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Updated: Jan 21, 2026

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
04:00

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension

Published on: November 15, 2024

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Esophageal Capsule Endoscopy in Children and Young Adults With Portal Hypertension

Anita K Pai1, Maureen M Jonas, Victor L Fox

  • 1Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA.

Journal of Pediatric Gastroenterology and Nutrition
|August 1, 2019
PubMed

Insights

Esophageal capsule endoscopy (ECE) is a safe and feasible method for screening and surveillance of esophageal varices in pediatric and young adult patients with portal hypertension. This minimally invasive technique offers a valuable alternative to traditional endoscopy for managing this high-risk group.

Area of Science:

  • Gastroenterology
  • Pediatric Hepatology
  • Endoscopic Technology

Background:

  • Variceal hemorrhage (VH) is a significant complication of portal hypertension (PH).
  • Screening and surveillance for esophageal varices are crucial in managing PH patients.
  • Traditional endoscopy (EGD) can be challenging in pediatric populations.

Purpose of the Study:

  • To evaluate the feasibility, safety, and clinical impact of esophageal capsule endoscopy (ECE).
  • To assess ECE's utility in pediatric and young adult patients with known or suspected PH.
  • To determine ECE's effectiveness as an alternative to EGD for variceal screening and surveillance.

Main Methods:

  • Retrospective review of 149 ECE studies in 98 pediatric and young adult patients with PH (2005-2017).
  • ECE performed for variceal screening (66.5%) or surveillance (33.5%).
  • Analysis of ECE findings, patient histories, and clinical outcomes, including subsequent interventions.

Main Results:

  • ECE detected varices in 44.9% of studies (59 esophageal, 17 gastric, 6 duodenal).
  • Other findings included portal gastropathy, esophagitis, erosions, and ulcers.
  • No major adverse events were reported; 2 transient capsule retentions occurred.
  • ECE led to follow-up EGD with banding in 7 patients and medication initiation in 12 patients.

Conclusions:

  • Esophageal capsule endoscopy is a feasible and safe alternative to EGD.
  • ECE is effective for screening and surveillance of esophageal varices in children and young adults with PH.
  • ECE provides valuable diagnostic information and influences management decisions in this population.
Abstract

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