Wireless Capsule Endoscopy in the Pediatric Age Group: Experience and Complications

Abstract

CE provides a valuable tool in the evaluation of pediatric patients for possible small bowel disease. However, the risk of developing complications appears to be greater in the pediatric population, with 20% of our patients having an adverse event.

Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED–ECCO consensus

“…Data from paediatric case series suggests that SBCE is superior to SBFT/SBE for detecting small-bowel pathology. Clinically relevant pathology was detected by SBCE, but not by SBFT/SBE in 10 of 20 children in another study [115].…”

“…Capsule retention is the most important adverse effect and can occur in either the stomach or strictured small bowel and require endoscopic or surgical removal. In 4 % -5 % of paediatric cases, the capsule was retained in the stomach and required endoscopic removal [115]. In a recent paediatric series [108], cap- sule retention occurred in 1/28 known cases of IBD.…”

“…In a recent paediatric series [108], cap- sule retention occurred in 1/28 known cases of IBD. In the paediatric literature there are reports of only three cases of capsule retention in strictured small bowel that did not respond to corticosteroids and required surgical intervention [108,111,115]. Use of a patency capsule can decrease the risk of capsule retention and has been used in paediatric patients with good effect [64].…”

Capsule endoscopy in pediatric patients

“…Capsule retention occurred in children, but not in adults with suspected Crohn's disease. In a cohort of 45 children undergoing WCE, nine subjects (20%) had adverse events [9] . Of these patients, five had delayed passage from the stomach with 2 patients requiring endoscopic retrieval and 4 had delayed passage from the small intestine (more than 5 d).…”

“…In this study, ileocolonoscopy and WCE complemented each other with respect to the extent of the disease. In a retrospective review of 46 WCE studies in children [9] (a denominator was not provided), among 9 children with newly diagnosed small intestinal Crohn's disease, seven (78%) had their treatment changed after WCE was done. Finally, PillCam SB was able to suggest the diagnosis of Crohn's disease in 2 adolescents with abdominal pain, protein loosing enteropathy and anemia with negative radiologic and endoscopic evaluation [10] .…”