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Clinical features of capsule endoscopy in 825 children: A single-center, retrospective cohort study
Jie Wu1, Zhiheng Huang1, Yuhuan Wang1
1Gastroenterology Department/Endoscopy Center.
Insights
Video capsule endoscopy (VCE) is safe and effective for diagnosing pediatric gastrointestinal diseases. This study found VCE has a 55.6% diagnostic yield, particularly for inflammatory bowel disease and obscure gastrointestinal bleeding in children.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
- Diagnostic Imaging
Background:
- Video capsule endoscopy (VCE) is a valuable tool for visualizing the gastrointestinal tract, especially the small bowel.
- Its application in pediatric populations for diagnosing various gastrointestinal diseases requires further evaluation.
Purpose of the Study:
- To assess the diagnostic utility and safety of VCE in children with suspected gastrointestinal conditions.
- To identify common indications and findings associated with VCE in pediatric patients.
Main Methods:
- Retrospective analysis of 828 pediatric patients who underwent VCE between December 2012 and December 2018.
- Evaluation of clinical data, VCE findings, completion rates, and diagnostic yield.
- Analysis of small bowel transit time in relation to specific diagnoses.
Main Results:
- VCE completion rate was 99.6% in 825 patients (average age 10.2 years).
- Overall diagnostic yield was 55.6% (459/828), with abdominal pain and hematochezia as primary indications.
- Small bowel ulcers (57.7%) were the most frequent abnormality, with 164 cases diagnosed as inflammatory bowel disease. Longer transit time was observed in the small bowel ulcer group (P < .01).
Conclusions:
- Video capsule endoscopy is a safe and well-tolerated procedure in children.
- VCE demonstrates significant value in diagnosing pediatric abdominal pain, particularly inflammatory bowel disease and obscure gastrointestinal bleeding.
Abstract:
Video capsule endoscopy (VCE) can detect mucosal lesions in the intestine, especially in the small bowel.Our study aims to evaluate the applications of VCE for pediatric gastrointestinal diseases.In this retrospective study, we included all patients who underwent VCE between December 2012 and December 2018. Clinical information and VCE data were analyzed.Among 828 patients, the completion rate was 99.6% (n = 825), with an average age of 10.2 ± 3.3 years old. A total of 459 VCE procedures showed abnormalities, and the overall diagnostic yield was 55.6%. The most common indications for VCE were abdominal pain among 505 (61.2%) patients and hematochezia (10.1%) among 83. Among the positive results of VCE, small bowel ulcers accounted for the highest percentage (57.7%), of which 164 cases were diagnosed as inflammatory bowel disease. For obscure gastrointestinal bleeding, 12 cases were diagnosed as Meckel's diverticulum. In terms of the small bowel transit time of VCE, compared with the negative group [288 (216.5, 390.3) min] and the enteritis group [277 (192.5, 374.8) min], a longer transit time was needed in the small bowel ulcer group [332.5 (240, 451.5) min, P < .01]. There were no correlations of positive VCE findings with anemia, the white blood cell count, the C-reactive protein level or the small bowel transit time according to Spearman rank analysis.VCE is relatively well tolerated and safe in children and has great value for the diagnosis and treatment of abdominal pain, especially inflammatory bowel disease and obscure gastrointestinal bleeding.
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