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Laparoscopy-assisted Surgical Removal of a Retained Wireless Capsule Endoscopy -A case report-

대한대장항문학회지 2006년 22권 3호 p.192 ~ 196
이상훈 ( Lee Sang-hoon ) - 성균관대학교 의과대학 삼성서울병원 외과학교실

한상아 ( Han Sang-Ah ) - 성균관대학교 의과대학 삼성서울병원 외과학교실
박치민 ( Park Chi-Min ) - 성균관대학교 의과대학 삼성서울병원 외과학교실
윤성현 ( Yun Seong-Hyeon ) - 성균관대학교 의과대학 삼성서울병원 외과학교실
이우용 ( Lee Woo-Yong ) - 성균관대학교 의과대학 삼성서울병원 외과학교실
전호경 ( Chun Ho-Kyung ) - 성균관대학교 의과대학 삼성서울병원 외과학교실

Abstract


Occult bleeding of the gastrointestinal tract is a major cause of iron deficiency anemia. Even with endoscopic evaluation of the upper and the lower gastrointestinal tract in these patients, in 30∼50% of the cases, the cause of bleeding still remains undiscovered. Wireless capsule endoscopy (WCE) is a novel method of evaluating the small bowel mucosa by using a small capsule equipped with a camera and transmission device. Complications of WCE include impaction within the gastrointestinal tract, sometimes requiring surgical removal. The authors report a case of capsule impaction in the small bowel in a patient evaluated for anemia due to occult gastrointestinal tract bleeding. The patient is a 19 year-old female with a history of anemia since age 4. The stool guaiac test was positive, but upper and lower gastrointestinal tract endoscopy showed no abnormalities, so WCE was done. A short segment of circular ulcers with lumen narrowing were seen in the distal jejunum. Seven days after ingestion of the capsule, the patient denied passage of the capsule. Small bowel enteroclysis was performed, and the capsule was seen along with a segment of lumen narrowing distal to the site of retention. Surgery was done, and upon laparoscopic examination, the entire bowel appeared normal. Retrieval of the capsule was done along with a resection of an 8 cm segment of the small bowel. Three linear ulcers were seen in the resected bowel specimen. Pathology revealed no evidence of Crohn’s disease or tuberculosis. The patient is still on iron supplements, but her hemoglobin level remains stable at 11∼12 g/dl. J Korean Soc Coloproctol 2006;22:192-196

키워드

캡슐내시경;위장 출혈;합병증
Wireless capsule endoscopy;Gastrointestinal tract bleeding;Surgical complications
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