Background: Videocapsule endoscopy (VCE) is a non-invasive method for examining the small bowel. Nevertheless VCE retention is the most significant complication of these devices and may occur in any location of the gastrointestinal tract. A patency capsule (PC) is used to safely perform VCE, in patients with an increased risk of VCE retention. A recent report raised some concerns about PC safety in 2 patients with suspected CD, but there were some limitations since one of the PC expiry date was exceededhttps://planner.smart-abstract.com/ecco2017/submission/en/abstract/4483/content#. Our aim was to assess the safety of PC in patients with Crohn's disease (CD) or suspected CD, in routine clinical practice.
Methods: Retrospective single-center study including patients with CD or suspected CD with clinical indication for VCE, between January 2011 and October 2016. PillCam PC (Given Imaging®) was performed in all patients to access small-bowel patency, without previous bowel preparation. PC detection was performed 30 hours after ingestion with radiofrequency identification (RFID) scanner. Patients with a positive identification of PC were considered to not have patency of the gastrointestinal tract and did not performed VCE. Symptomatic PC retention was defined as the presence of typical obstructive abdominal symptoms (i.e. postprandial colicky abdominal pain/bloating/vomiting).
Results: During the period of the study, were performed 451 PC (60% women, with a mean age of 39±13 years). Fifty-eight per cent of cases had a suspected CD and 42% of cases had a previous diagnosis of CD. Twenty-seven per cent of cases had a known or suspected small-bowel stenosis detected by previous ileocolonoscopy or abdominal imaging and 26% of cases had a history of previous abdominal surgery. The retention rate 30h after PC ingestion was 27% (31% in patients with CD vs. 24% in patients with suspected CD, p>0.05). All 322 patients with confirmed small bowel patency performed VCE, without incidents. Six (1.3%) patients presented a symptomatic PC retention (5 with CD and 1 with suspected CD, p>0.05). Two (0.4%) cases (with CD) were admitted due to small-bowel obstruction, which was successfully managed with corticosteroids.
Conclusions: The PC test has proven to be a safe modality for securing small bowel patency prior to capsule endoscopy, with reduced frequency of symptomatic retention, which occurred almost exclusively in patients with a previous diagnosis of CD.
 Rasmussen B, Nathan T, Jensen MD., (2016), Symptomatic Patency Capsule Retention in Suspected Crohn's Disease, J Crohns Colitis