PDF(Pubmed)
Abstract：
UNASSIGNED: Gastro-oesophageal reflux disease (GORD) is a common chronic condition affecting up to 20 %. Proton pump inhibitor (PPI) is considered 1st line therapy however 10-40 % of patients do not respond adequately subsequently requiring further investigations. One of these investigations includes oesophageal pH testing via a wireless capsule placed into the oesophagus, which may remain there for up to 96 h before being self-displaced. Our report describes a rare case of oesophageal pH capsule retention and proposes a pragmatic approach to its management including endoscopic removal.
METHODS: A 33 year-old male attended our out-patient clinic with ongoing reflux symptoms and intermittent dysphagia. His response to first line therapy including lifestyle modifications and with PPIs was unsatisfactory thus a plan for an oesophageal Ph capsule study was agreed and performed. On day 4 post-procedure he reported severe dysphagia to solid foods. A Chest X-ray was performed which confirmed the presence of the capsule 7 days post-procedure. On day 12 post-procedure, gastroscopy and retrieval of the capsule was performed successfully.
UNASSIGNED: We recommend gastroenterologists use submucosal elevation in combination with manual traction in order to detach the capsule from the underlying mucosa, followed by retrieval using forceps to grab the thread-end of the capsule.
CONCLUSIONS: We hope our report raises awareness for this rare complication as well as providing education to practicing gastroenterologists on a formal manoeuvre for successful endoscopic management of a retained oesophageal pH capsule.
METHODS: A 33 year-old male attended our out-patient clinic with ongoing reflux symptoms and intermittent dysphagia. His response to first line therapy including lifestyle modifications and with PPIs was unsatisfactory thus a plan for an oesophageal Ph capsule study was agreed and performed. On day 4 post-procedure he reported severe dysphagia to solid foods. A Chest X-ray was performed which confirmed the presence of the capsule 7 days post-procedure. On day 12 post-procedure, gastroscopy and retrieval of the capsule was performed successfully.
UNASSIGNED: We recommend gastroenterologists use submucosal elevation in combination with manual traction in order to detach the capsule from the underlying mucosa, followed by retrieval using forceps to grab the thread-end of the capsule.
CONCLUSIONS: We hope our report raises awareness for this rare complication as well as providing education to practicing gastroenterologists on a formal manoeuvre for successful endoscopic management of a retained oesophageal pH capsule.
摘要：
■胃食管反流病（GORD）是一种常见的慢性病，影响高达20％。质子泵抑制剂（PPI）被认为是一线治疗，但是10-40％的患者随后没有足够的反应，需要进一步的研究。其中一项研究包括通过放置在食道中的无线胶囊进行食道pH测试，在自我流离失所之前，它可能会在那里停留长达96小时。我们的报告描述了一种罕见的食管pH胶囊保留病例，并提出了一种实用的治疗方法，包括内镜下切除。
方法：一名33岁男性因持续的反流症状和间歇性吞咽困难而就诊于我们的门诊。他对包括生活方式改变和PPI在内的一线治疗的反应不令人满意，因此同意并执行了食道Ph胶囊研究计划。手术后第4天，他报告固体食物严重吞咽困难。在手术后7天进行胸部X射线检查，证实了胶囊的存在。在手术后的第12天，成功进行了胃镜检查和胶囊取出。
■我们建议胃肠病学家将粘膜下抬高与手动牵引结合使用，以使胶囊与下面的粘膜分离，然后使用镊子抓取胶囊的线端。
结论：我们希望我们的报告能提高人们对这种罕见并发症的认识，并对胃肠病医师进行正式操作，以成功地内镜下保留的食管pH胶囊进行治疗。
方法：一名33岁男性因持续的反流症状和间歇性吞咽困难而就诊于我们的门诊。他对包括生活方式改变和PPI在内的一线治疗的反应不令人满意，因此同意并执行了食道Ph胶囊研究计划。手术后第4天，他报告固体食物严重吞咽困难。在手术后7天进行胸部X射线检查，证实了胶囊的存在。在手术后的第12天，成功进行了胃镜检查和胶囊取出。
■我们建议胃肠病学家将粘膜下抬高与手动牵引结合使用，以使胶囊与下面的粘膜分离，然后使用镊子抓取胶囊的线端。
结论：我们希望我们的报告能提高人们对这种罕见并发症的认识，并对胃肠病医师进行正式操作，以成功地内镜下保留的食管pH胶囊进行治疗。
