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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

WIRELESS CAPSULE ENDOSCOPY: EXPERIENCE AT A TERTIARY CHILDREN'S HOSPITAL: 118

Lee, Kenneth K

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Journal of Pediatric Gastroenterology and Nutrition: October 2005 - Volume 41 - Issue 4 - p 529
doi: 10.1097/01.mpg.0000181974.63861.89
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Background:

Wireless capsule endoscopy (WCE) is a relatively new technique to directly visualize the small bowel whose use is rapidly expanding. WCE has been increasingly used in pediatric patients, but published data in this group is limited. The pediatric experience in WCE at one tertiary children's hospital is described.

Methods:

Records of ten pediatric patients who underwent WCE at Children's Hospital of Wisconsin Feb 2005-May 2005 were retrospectively reviewed and abstracted for indications, placement method, findings, and complications.

Results:

The patients included 5 males and 5 females, age range 5-16 years (mean 12 years). Presenting symptoms included abdominal pain (5), anemia (3), joint pain/arthralgia (4), vomiting (2), pelvic abscess (1), and nausea (1). None had signs of overt gastrointestinal bleeding. All had esophagogastroduodenoscopy (EGD) and colonoscopy performed prior to WCE referral and all were normal, including ileum. Nine patients underwent upper gastrointestinal (UGI) and small bowel follow-through (SBFT) contrast studies; 6 were normal. Five patients required EGD placement in the duodenum. 8/10 WCE's were successfully completed and demonstrated the entire small bowel. One of the 2 patients with incomplete WCE retained the capsule and was subsequently found to have an idiopathic ileal stricture. No other significant complications were reported. 8/10 WCE's showed no small bowel abnormalities. The other 2 WCE's showed small bowel ulcerations and erosions suggestive of Crohn's disease (CD), including the 5-year-old patient. The colonoscopy biopsy specimens of one of these patients, previously interpreted as normal, were re-reviewed and granulomas and chronic inflammation consistent with CD was found. Symptoms in both resolved with CD treatment.

Conclusions:

WCE is a useful diagnostic tool for small bowel disorders. The indications for WCE continue to evolve and increased experience with WCE in pediatric patients is needed to both define its indications and delineate its capabilities and limitations.

© 2005 Lippincott Williams & Wilkins, Inc.