캡슐내시경 시행 후 배출 장애에 의해 복강경을 이용한 제거수술을 받은 환자 1예

Occult bleeding of the gastrointestinal tract is a major cause of iro 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 moethod 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 te 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 abnomalities, 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 8cm 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