Delayed presentation of an aspirated capsule endoscope
A 56-year-old gentleman presented with a 2-week history of progressive shortness of breath following a coughing fit whilst having a meal. He is a reformed smoker, with mild chronic airway disease, hypertension, gout and a left-sided cerebrovascular accident (CVA) in 2006 with complete neurological recovery. He had been investigated 6 weeks previously for iron deficiency anaemia with a capsule endoscopy, which was reportedly ‘lost’ during the procedure. An esophagogastroscopy performed immediately failed to locate the capsule. The patient refused any further investigations to locate the capsule.\nChest X-ray (Fig. ) and computed tomography (CT) scan (Fig. ) revealed a foreign body in the right bronchus intermedius with collapse and consolidation of the distal bronchial tree. The gentleman was transferred to the cardiothoracic unit. An adult Negus rigid bronchoscope introduced under general anaesthesia revealed a metallic foreign body with smooth rounded contours wedged in the bronchus intermedius. This was removed using a Wolfe lighted grabber. The foreign body was a capsule endoscope (Given Imaging Limited, Israel) (Fig. ).\nThe patient received post-operative antibiotics and intensive physiotherapy. Chest X-ray prior to discharge revealed complete resolution of the atelectasis and consolidation. The patient continues to do well on follow-up. On retrospective questioning the patient denied any problems in swallowing the capsule endoscope.