Abstracts: North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition Annual Meeting October 20-22, 2005 Salt Lake City, Utah: POSTER SESSION II FRIDAY, OCTOBER 21, 2005 12:15PM - 2:15PM: Video and Capsule Endoscopy
Capsule endoscopy (CE) has been well tolerated in patients with Crohns Disease (CD) with minimal capsule retention. However, this safety profile has not yet been well established in children and adolescents.
The Patency Capsule (PatCap) is an ingestible, dissolvable capsule containing a radiofrequency identification tag and is the same size as the PillCam SB Capsule. A timer plug erodes and allows dissolution of the capsule's body. The remaining fragments of the capsule can pass even small orifices. An ongoing, single center, prospective study evaluating the impact of CE on CD management used the PatCap with a single timer plug to screen patients for inclusion. Those passing the PatCap within 40 hrs were able to undergo CE within the study. Those failing to pass the capsule within that time period could have CE performed outside the study.
Twelve patients (ages 12-18 years) ingested the PatCap. Five excreted the PatCap within the set time of 40 hrs. (mean 20.8) and proceeded with CE. Four patients who excreted the PatCap beyond the allotted time also underwent CE (2 had a complete SB studies, and all 4 excreted the PillCam). In 2 patients, small bowel obstructive symptoms required hospitalization. One underwent resection with the disintegrated capsule found distal to his strictured ileum. The other, whose PatCap was never recovered, was discharged on medical therapy. Of the other 10 PatCap, 1 was excreted intact at 12 hrs; 6 were disintegrating at the time of passage (range 8.6-72.9 hrs); 2 were not returned. In the 1 patient passing the capsule after 130 hrs, the PatCap had disintegrated completely. No apparent difference in age, height, weight, or eventual diagnosis distinguished those who passed the PatCap in the allotted time from those who did not.
This first pediatric and first US report of PatCap experience demonstrates that patency evaluation may be useful in pediatric CD where there is concern about potential retention of the PillCam SB capsule. Further studies may show broader applicability.