Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Over the past decade, capsule endoscopy has become the accepted modality for small bowel imaging in the United States. It is very helpful in making the diagnosis of Crohn’s disease; however, this patient population is also at an increased risk of small bowel obstruction secondary to capsule impaction. We present the case of a 60-year-old female with undiagnosed Crohn’s disease who presented to the emergency department with small bowel obstruction after capsule ingestion. She was successfully disimpacted with diatrizoate upper gastrointestinal (GI) series with small bowel follow-through and intravenous steroids. Review of the endoscopic video images revealed findings consistent with Crohn’s disease. [West J Emerg Med. 2010; 11(1):71-73.]