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... present a case of a 16-year-old male with a known case of celiac disease (CD). He presented to our emergency room with abdominal pain and distention for 2 days duration. Upon questioning it was revealed that he was admitted several weeks earlier in another hospital for investigation of his weight loss and abdominal pain. The results of his investigations were not conclusive at that time. Therefore, he was scheduled for capsule endoscopy. The procedure took place 3 weeks before his current presentation. The patient had the impression and misconception that the capsule endoscope could stay for long time without a problem. He was demonstrating a picture of a complete intestinal obstruction, abdominal pain, abdominal distension, and obstipation. Results from a systemic exam were unremarkable. An abdominal exam revealed a scar from a diagnostic laparoscopy done 2 years earlier to treat his CD. On physical examination, a diffusely distended abdomen with hyperactive bowel sounds were elicited. The patient showed no evidence of hernia. The results from his laboratory investigations were within normal ranges apart from iron deficiency anemia. An abdominal x-ray showed a retained capsule endoscope in the small bowel ( Figure 1). A computed tomography (CT) scan of the abdomen with double contrast confirmed this finding (Figure 2). Due to his previous surgery with the expectation of extensive adhesion, we elected to go for an exploratory laparotomy which revealed a dilated small bowel with a grossly diseased ileal segment around 60 cm proximal to the ileocecal junction. The bowel wall was thick and erythematous with areas of multiple strictures (Figure 3a). The capsule endoscope was impacted between 2 stricture points. Enterotomy and complete extraction was achieved (Figure ...
