Endoscopy 2005; 37(6): 591-593
DOI: 10.1055/s-2005-861320
Case Report
© Georg Thieme Verlag KG Stuttgart · New York

Extraction of Entrapped Capsules from the Small Bowel by Means of Push-and-Pull Enteroscopy with the Double-Balloon Technique

A.  May1 , L.  Nachbar1 , C.  Ell1
  • 1Dept. of Internal Medicine II, HSK Wiesbaden (Teaching Hospital of the University of Mainz), Wiesbaden, Germany
Further Information

Publication History

Submitted 21 December 2004

Accepted after Revision 12 January 2005

Publication Date:
03 June 2005 (online)

The new technique of push-and-pull enteroscopy using the double-balloon technique (double-balloon enteroscopy) makes it possible to remove swallowed foreign bodies causing intestinal obstruction deep in the small bowel without the need for surgical laparotomy. This report describes two cases of enteroscopic removal of entrapped capsules. In one patient with acute recurrent intestinal bleeding and recurrent abdominal pain, Crohn’s disease had been suspected on capsule endoscopy. The second patient, with known Crohn’s disease, was suffering from abdominal pain and underwent capsule endoscopy for investigation of the small bowel. Prior enteroclysis had not revealed stenoses in either patient. An oral approach was chosen and the capsules were identified approximately 140 cm and 310 cm from the pylorus, respectively, in front of stenoses. The capsule endoscopes were removed successfully in both patients by means of push-and-pull enteroscopy using a new enteroscope device.

  • 1 Ell C, Remke S, May A. et al . The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding.  Endoscopy. 2002;  34 685-689
  • 2 Eliakim R, Fischer D, Suissa A. et al . Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn’s disease.  Eur J Gastroenterol Hepatol. 2003;  15 363-367
  • 3 Herrerias J M, Aunedo A, Rodriguez-Téllez M. et al . Capsule endoscopy in patients with suspected Crohn’s disease and negative endoscopy.  Endoscopy. 2003;  35 564-568
  • 4 Ge Z Z, Hu Y B, Xiao S D. Capsule endoscopy in diagnosis of small bowel Crohn’s disease.  World J Gastroenterol. 2004;  10 1349-1352
  • 5 Eliakim R, Suissa A, Yassin K. et al . Wireless capsule video endoscopy compared to barium follow through and computerized tomography in patients with suspected Crohn’s disease: final report.  Dig Liver Dis. 2004;  36 519-522
  • 6 Sears D M, Avots-Avotins A, Culp K, Gavin M W. Frequency and clinical outcome of capsule retention during capsule endoscopy for GI bleeding of obscure origin.  Gastrointest Endosc. 2004;  60 822-827
  • 7 Cheifetz A S, Sachar D B, Lewis B S. Small bowel obstruction: indications or contraindications for capsule endoscopy [abstract].  Gastrointest Endosc. 2004;  59 461
  • 8 Yamamoto H, Sekine Y, Sato Y. et al . Total enteroscopy with a nonsurgical steerable double-balloon method.  Gastrointest Endosc. 2001;  53 216-220
  • 9 May A, Nachbar L, Wardak A. et al . Double-balloon enteroscopy: preliminary experience in patients with obscure gastrointestinal bleeding or chronic abdominal pain.  Endoscopy. 2003;  35 985-991
  • 10 Yamamoto H, Kita H, Sunada K. et al . Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases.  Clin Gastroenterol Hepatol. 2004;  2 1010-1016
  • 11 May A, Nachbar L, Schneider M, Ell C. Push-and-pull enteroscopy using the double-balloon technique (double-balloon enteroscopy) of the small bowel: Feasibility, diagnostic and therapeutic yield in patients with suspected small bowel diseases.  Gastrointest Endosc. (in press); 
  • 12 May A, Nachbar L, Schneider M. et al . Push-and-pull enteroscopy using the double-balloon technique: method of assessing depth of insertion and training of the enteroscopy technique using the Erlangen Endo-Trainer.  Endoscopy. 2005;  37 66-70
  • 13 Kastin D A, Buchman A L, Barrett T. et al . Strictures from Crohn’s disease diagnosed by video capsule endoscopy.  J Clin Gastroenterol. 2004;  38 346-349
  • 14 Costamagna G, Spada C, Spera G. et al . Evaluation of the Given patency system in the GI tract: results of a multi-center study [abstract].  Gastrointest Endosc. 2004;  59 M1697
  • 15 Spada C, Spera G, Riccioni M E. et al . M2A patency capsule prior to video capsule endoscopy in patients with morphological small bowel strictures [abstract].  Gastrointest Endosc. 2004;  59 M1698

A. May, M.D., Ph. D.

Dept. of Internal Medicine II, HSK Wiesbaden

Ludwig-Erhard-Strasse 100 · 65199 Wiesbaden · Germany

Fax: +49-611-43-2418

Email: ADinahMay@aol.com

    >