Clinical impact and diagnostic yield of small bowel capsule endoscopy in children

To understand the clinical utility of small bowel video capsule endoscopy (VCE) based on indications, diagnostic yield, and management for pediatric patients suffering from disorders of the small bowel.

A single-center retrospective chart review was performed at Children's Health in Dallas, Texas between 2004 and 2022. Pediatric patients who underwent small bowel VCE were identified by Medtronic's Rapid PillCam Reader Software, and studies were organized by their primary indication. Chi-squared analysis was used to compare the rates of positive studies and studies leading to therapy or diagnostic plan changes by indication.

Our analysis included 478 completed VCE studies of which 245 (51.3%) were positive and 169 (35.4%) led to therapy or diagnostic plan changes. The median age of patients was 12 years (range: 10 months to 18 years; interquartile range 8, 15) with 58.8% male patients. Compared to other indications, VCE studies performed for abdominal pain are less likely to be positive (p = 0.0003) and lead to fewer therapy and diagnostic plan changes (p = 0.0037).

VCE is useful in diverse clinical settings to diagnose and monitor small bowel pathologies. It leads to fewer changes in clinical management when the primary indication is abdominal pain.