Remote/virtual Endoscopy 'hiccup'

The image at the top right shows a virtual endoscopy probe that has become lodged in a segment of small bowel. The patient had chronic Crohn's disease and, as a result, had multi-focal small bowel strictures; one of which is immediately distal to the probe. The probe created a complete obstruction, exacerbated local inflammation; necessitating the excision of the segment.

I was sorry to see that the batteries had died by the time the specimen arrived in our department (the unit flashes four LED lights every 4 seconds or so). We could have smiled for the camera!

This specimen clearly indicates a contra-indication to virtual endoscopy; ie. in some patients with known chronic Crohn's ileitis.