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Capsule endoscopy in pediatric patients: technique and results in our first 100 consecutive children
Hannu Nuutinen1, Kaija-Leena Kolho, Päivi Salminen
1Clinic of Gastroenterology, Helsinki University Central Hospital, University of Helsinki, Finland. hannu.nuutinen@hus.fi
Insights
Capsule endoscopy (CE) is a feasible diagnostic tool for pediatric small bowel evaluation, even in infants as young as 8 months. It shows high diagnostic yield for bleeding and suspected Crohn's disease.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Endoscopy
Background:
- Capsule endoscopy (CE) is a minimally invasive technique for small bowel assessment.
- Limited data exist on CE feasibility, safety, and findings in pediatric populations.
Purpose of the Study:
- To evaluate the feasibility, safety, and diagnostic yield of CE in 100 consecutive pediatric patients.
- To determine the effectiveness of CE for various gastrointestinal indications in children.
Main Methods:
- Retrospective analysis of 100 pediatric CE procedures at a single center.
- Indications included suspected Crohn's disease (35), ulcerative colitis (24), gastrointestinal bleeding (18), and others (23).
- Patient age ranged from 8 to 188 months; capsule assistance was used in 51 patients.
Main Results:
- CE was feasible in children as young as 8 months.
- Significant findings were observed in 39% of patients, including ulcers, bleeding, tumors, and strictures.
- Diagnostic yield was 50% for bleeding and 60% for suspected Crohn's disease.
Conclusions:
- Capsule endoscopy is a safe and effective method for evaluating small bowel pathology in children.
- CE offers a high diagnostic yield for specific indications like gastrointestinal bleeding and suspected Crohn's disease in pediatric patients.
Objective:
Capsule endoscopy (CE) offers noninvasive methods to assess small bowel pathology but only limited data are available on the feasibility, safety, and findings in children. In this study, we report our results of 100 consecutive CE in children.
Material And Methods:
Single center retrospective study. All pediatric patients (mean age 119 months, range from 8 to 188 months) undergoing CE were included until 100 investigations were completed. The indications for CE were: suspicion or evaluation of Crohn's disease (n = 35) or ulcerative colitis (n = 24), gastrointestinal bleeding (n = 18), and miscellaneous (n = 23).
Results:
The youngest patients able to swallow the capsule were 84 months old. When the patient was unable to swallow the capsule (n = 51), it was guided into the duodenum with endoscope. In two patients, the capsule remained in the stomach during the 8 h of recording and in 23 cases the capsule failed to reach the cecum. The capsule was expelled naturally in all except one patient. In 39% of the patients, CE revealed a significant finding (multiple ulcers, bleeding, tumors, strictures). In patients examined for bleeding or for a suspicion of Crohn's disease, the respective proportions were 50% and 60%.
Conclusions:
This study shows that CE is a feasible diagnostic method to study the small intestine in pediatric patients and that CE can be done in children as young as 8 months old. The diagnostic yield is highest in cases with bleeding or a high suspicion of Crohn's disease.
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