Regarding the Letter to the Editor written by Dr. Diego García-Compean related to the article «Bowel obstruction due to capsule endoscopy in a patient with Peutz-Jeghers syndrome» by Roesch-Dietlen et al.,1 we completely agree with his comments on how to prevent, diagnose, and manage that complication, and would like to add the following:
Without a doubt, video capsule (VC) retention is the most dreaded event of the procedure, with an overall prevalence of 2%, especially in patients with diseases that affect the caliber of the intestinal lumen. However, when the decision was made to perform the study, there were no signs or symptoms suggestive of obstruction, which was why we did not consider it pertinent to carry out bowel transit or computed tomography with oral contrast medium, or use the degradable Agile capsule, in addition to the fact that unfortunately said capsule is not available in Mexico and its results are still controversial.2
We agree that management should be conservative and that the procedure of choice for resolving capsule impaction is single-balloon or double-balloon enteroscopy. Its success rate is usually high, although there is little experience with the procedure in Mexico, as stated by García-Correa et al. in their study on a group of 19 patients treated at the Centro Médico de Occidente of the IMSS in Guadalajara.3 We attempted to resolve the obstruction in our patient on the seventh day through double-balloon enteroscopy, but it was not successful because of the impaction of the capsule at the stricture site in the terminal ileum. The complication was satisfactorily resolved through bowel resection of the affected zone.
We are in total agreement with the proposed measures for reducing the possibility of video capsule retention that Dr. García-Compean cites in his Letter to the Editor.4
Financial disclosureNo financial support was received in relation to this study/article.
Conflict of interestThe authors declare that there is no conflict of interest.
Please cite this article as: Roesch-Dietlen F, Cano-Contreras AD, Meixueiro-Daza A, Remes-Troche JM, Grube-Pagola P. «A propósito de la retención de cápsula endoscópica: cómo prevenir, diagnosticar y manejar esta complicación» de Diego García-Compean. Revista de Gastroenterología de México. 2018;83:362–363.