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Use of a Real-time Viewer for Endoscopic Deployment of Capsule Endoscope in the Pediatric Population

Bass, Lee M.; Misiewicz, Lawrence

Journal of Pediatric Gastroenterology & Nutrition: November 2012 - Volume 55 - Issue 5 - p 552–555
doi: 10.1097/MPG.0b013e318261879d
Original Articles: Gastroenterology

Objectives: Wireless capsule endoscopy (WCE) is an increasingly used procedure for visualization of the small intestine. One challenge in pediatric WCE is the placement of the capsule in a population unable to swallow it for a variety of reasons. Here we present a novel use of the real-time (RT) viewer in the endoscopic deployment of the capsule endoscope.

Methods: We performed a retrospective chart review on all WCE completed at the Children's Memorial Hospital from February 2010 to May 2011. Following a diagnostic upper endoscopy, the RT viewer was attached to the capsule recorder and image was noted before insertion. The endoscope and AdvanCE capsule delivery device were slowly advanced into duodenum while maintaining visualization on the RT viewer.

Results: A total of 17 patients who underwent a WCE with endoscopic placement were identified. They ranged in ages from 2 to 19 years. Thirteen patients required endoscopic placement because of the inability to swallow the capsule, whereas 4 were placed during a scheduled procedure to take advantage of sedation and airway protection. All of the 17 patients had successful deployment of the capsule into the duodenal lumen. In each case, the endoscopist was able to confirm capsule location in duodenum during scope withdrawal. There was no evidence of iatrogenic trauma or bleeding in any patient. There were 5 incomplete studies, a completion rate consistent with that described in the literature.

Conclusions: The use of the RT viewer for endoscopic deployment of WCE is an effective technique to improve visualization of capsule placement in the pediatric population.

Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.

Address correspondence and reprint requests to Lee Bass, MD, Division of Gastroenterology, Hepatology and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Av, Box 65, Chicago, IL 60611 (e-mail: lbass@childrensmemorial.org).

Received 16 December, 2011

Accepted 3 May, 2012

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN