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WIRELESS CAPSULE ENDOSCOPY: INITIAL PEDIATRIC EXPERIENCE: 117

Mohr, Franziska; Kay, Marsha; Wyllie, Robert; Mahajan, Lori

Journal of Pediatric Gastroenterology and Nutrition: October 2005 - Volume 41 - Issue 4 - p 529
doi: 10.1097/01.mpg.0000181973.63861.47
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
Free

Pediatric Gastroenterology, Cleveland Clinic Foundation, Cleveland, OH

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Background and Study Aims:

Wireless capsule endoscopy (WCE) allows painless imaging of the small bowel without radiation and aids in the diagnosis of obscure small bowel disease in adults. To date there is only very limited data regarding the use of WCE in pediatric patients and endoscopic deployment has not been reported in children. The aim of our study was to determine the indications, feasibility, outcome and complications of WCE in children.

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Patients and Methods:

An IRB approved retrospective chart review of 17 patients (11 F: 6 M) with a mean age of 14.8yrs (7.6-19.2 yrs) and mean weight of 49.2 kg (24-84.2 kg) undergoing WCE was performed. Indications included possible Crohn's (CD) disease in 13, assessment of degree of involvement in 2 known IBD patients and occult bleeding in 2. 13 patients swallowed the capsule without difficulty. Endoscopic deployment was performed in the remaining 4 patients using a through-the-channel WCE deployment device.

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Results:

All studies were successfully completed. Mean small bowel transit time was 266 min. (76-510 min.). The capsule was positioned at the IC valve at the end of the study in 2 patients and passed without complication in all. No complications were encountered during or after the procedure. 7 studies (41.2%) showed abnormalities: small bowel lesions consistent with Crohn's disease in 5 patients (29%), enterobiasis in 1 patient (5.8%) and gastritis in 1 (5.8%) patient. In addition a small 2 mm polyp was identified in one of the patients with CD. The findings on capsule endoscopy altered the management in 5 patients (29%) by either establishing a new diagnosis or initiating a change of therapy and eliminated additional testing in 5 additional patients (29%).

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Conclusions:

WCE is a valuable diagnostic tool in children with suspected small bowel disease particularly in Crohn's disease not confirmed by conventional testing. WCE can be performed safely in young or small pediatric patients. The capsule can be endoscopically deployed in those patients unable to swallow the device because of patient age, size or impaired swallowing.

© 2005 Lippincott Williams & Wilkins, Inc.