A 36-year-old man with chronic kidney disease on main- tenance hemodialysis was evaluated elsewhere for obscure GI bleeding requiring multiple blood transfusions. A capsule endoscopy (CE) performed at that center showed ileal stricture and poor progression of the capsule beyond the stricture. CT showed the CE device in the proximal ileal loop, with no signs of small-bowel obstruction. Laboratory test results showed highly sensitive C-reactive protein and fecal calprotectin levels (>500 mg/mg) suggestive of inflam- matory bowel disease. He was treated with oral steroids for suspected Crohn’s disease and management of retained capsule. After 6 months, on patient preference, retrograde enteroscopy was attempted at that center for persistent prolonged capsule retention but was unsuccessful. He was referred to us for further management.
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