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Feasibility and Safety of Small Bowel Capsule Endoscopy in Very Early-Onset Inflammatory Bowel Disease: A
Shin-Ichiro Hagiwara1, Hirotaka Shimizu2,3, Ryusuke Nambu4
1Department of Gastroenterology, Nutrition, and Endocrinology, Osaka Women's and Children's Hospital, Osaka, Japan.
Insights
Small bowel capsule endoscopy is feasible and safe for diagnosing very early-onset inflammatory bowel disease in children. This procedure aids in identifying lesions and can be performed safely with patency capsule evaluation.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Endoscopy
Background:
- Small bowel capsule endoscopy (SBCE) is crucial for pediatric inflammatory bowel disease (IBD).
- Limited data exists on SBCE for very early-onset IBD (VEO-IBD).
Purpose of the Study:
- To investigate the feasibility and safety of SBCE in children with VEO-IBD.
- To assess the diagnostic utility of SBCE in this population.
Main Methods:
- Retrospective review of 104 SBCE procedures in 82 patients under 6 years old with VEO-IBD.
- Data collected from 7 Japanese pediatric centers (2013-2022).
- Analysis of procedure success, safety, and findings, including patency capsule use.
Main Results:
- SBCE was successfully deployed in all cases, primarily with delivery devices (95%).
- Abnormal small bowel findings were present in 42% of patients (aphthae 34%, ulcers 18%).
- No serious complications like retention or perforation were reported; patency capsules were used in 95%.
Conclusions:
- SBCE is a feasible and safe diagnostic tool for VEO-IBD in children.
- Appropriate safety evaluations, including patency capsules, are essential for successful SBCE in this age group.
Background:
Small bowel capsule endoscopy is a valuable modality for evaluating small intestinal lesions in children with inflammatory bowel disease. However, its application for very early-onset inflammatory bowel disease remains insufficiently documented. This study investigated the feasibility and safety of small bowel capsule endoscopy for very early-onset inflammatory bowel disease.
Methods:
A cohort of patients with very early-onset inflammatory bowel disease who underwent small bowel capsule endoscopy at under 6 years of age between January 2013 and December 2022 at 7 Japanese pediatric centers was included. Their medical records were retrospectively reviewed for actual procedures, safety, and test results.
Results:
Eighty-two patients (21 with ulcerative colitis, 25 with Crohn's, 31 with inflammatory bowel disease-unclassified, 4 with monogenic inflammatory bowel disease, and 1 with intestinal Behçet's disease) were enrolled, and 104 small bowel capsule endoscopies (median age, 3.8 years; median body weight, 13.0 kg) were analyzed. All capsules were deployed endoscopically, mostly using delivery devices (95%). Gastrointestinal patency was assessed in 95% of procedures, most commonly using patency capsules (70%). Abnormal small bowel findings were observed in 42% of patients, with aphthae being the most common (34%), followed by ulcers (18%). No serious complications, including small intestinal retention and perforation, were reported.
Conclusions:
Small bowel capsule endoscopy for very early-onset inflammatory bowel disease is feasible with diagnostic utility, and it can be performed safely with appropriate evaluation using patency capsules.
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