Wireless Capsule Endoscopy Years after Michelassi Stricturoplasty for Crohn's Disease

The use of wireless capsule endoscopy in Crohn's disease has been a matter of debate. We report the case of a 27-year-old woman operated for Crohn's disease with a Michelassi stricturoplasty presenting with anaemia. We tested the patient with a patency capsule before undertaking a wireless capsule endoscopy. Although the absorbable capsule was successfully expelled, the wireless capsule was retained next to the distal edge of the Michelassi stricturoplasty, where it revealed an otherwise undetected stenotic recurrence. We successfully treated the recurrence with a Heineke-Mikulicz stricturoplasty on the stenotic outlet of the previous Michelassi, extracting the capsule. We found our treatment effective. We believe that capsule endoscopy can be performed in patients operated on for Crohn's disease, although further studies are needed to clarify its role in patients with long-stricturoplasties and to establish which examination could be the most effective in selecting patients.