Article Text

CAPSULE ENDOSCOPY IN PEDIATRIC PATIENTS
  1. G Lesanu1,
  2. F Costea2,
  3. V Hurduc3,
  4. C Becheanu1,
  5. V Danila1,
  6. D Pacurar1,
  7. C Ulmeanu1
  1. 1Grigore Alexandrescu Emergency Children Hospital, Bucharest, Romania
  2. 2Mc Gill University, Montreal, QC, Canada
  3. 3Victor Gomoiu Children Hospital, Bucharest, Romania

Abstract

Objective We analyzed our initial experience with capsule endoscopy (CE) in pediatric practice.

Methods We retrospectively reviewed all the records of children who underwent CE at the Emergency Children’s Hospital. Eighteen patients (range 6–19 years), with suspected small bowel disease were selected. We reviewed the usefulness of the investigation and the adverse events.

Results Seventeen patients (mean age 13 years) swallowed the capsule without difficulty; only a 6 year old girl refused it. The indications for CE included: suspected Crohn’s disease (n = 5), obscure gastrointestinal bleeding (OGIB) (n = 3), Peutz-Jeghers syndrome (n = 1), recurrent abdominal pain (n = 3), unexplained syderopenic anemia (n = 1) and suspected celiac disease (4 asymptomatic patients with positive celiac serology). Crohn’s disease was confirmed in 2 cases and was excluded in 3 children (2 children with jejunitis). A possible small bowel bleeding source was identified in 2 patients with OGIB. Suggestive signs of celiac disease were noticed in 3 patients (duodenal biopsy demonstrated villous atrophy in 2 patients and normal histology in one patient) and in the patient with anemia (later confirmed via biopsy). Six records showed normal small bowel: OGIB (n = 1), recurrent abdominal pain (n = 3), suspected celiac disease (n = 1), suspected Crohn’s disease (n = 1). There were no adverse events after the ingestion of the capsule.

Conclusion CE revealed pathologic findings in 64.7% cases (definite diagnosis in 47% cases and a possible diagnosis in 17.7% cases) and was normal or non-diagnostic in 35.3% cases. CE was safe and helpful in the evaluation of pediatric patients with suspected bowel disease.

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