M1571: Capsule Endoscopy in Pediatric Patients: Technique and Results in Our First 94 Consecutive Children (8 Months to 16 Years of Age)

Abstract

We have made 94 Capsule Endoscopies in pediatric patients. Our youngest patient was only 8 months old and 26 of our patients were less than 8 years old. The average age of our patients was 10.5 years (range 0,7-16 years). The indications for Capsule Endoscopy were the following: Obscure or overt gastrointestinal bleeding (n= 17), suspicion or evaluation of Crohn's disease (n=31), evaluation of earlier diagnosed ulcerative colitis (indeterminate colitis; n=24) and 22 others (4 polyposis-syndromes, 7 protein losing enteropathies, 4 blood vessel anomalies and 7 others (intestinal pseudo-obstruction, abdominal pain etc.). The youngest patients to swallow the capsule were 7 years old, although usually patients more than 10 years old were able to swallow the capsule without any problems. In younger patients the capsule was taken in to the duodenum with gastroscopic quidance. In our first 3 patients we used a self made plastic tube to deliver the capsule into the stomach, in 12 patients we used Roth Net® and in 79 patients we used the newer Capsule Delivery Devise®. After the capsule had been released in the duodenum, the normal capsule endoscopy recording was made. 8 patients had nausea and vomiting during CE, but this was most probably caused by the anesthetic drugs. Otherwise the CE was done without any special problems. In 1 (0,5%) patient of those who could swallow the capsule, the capsule stayed in the stomach during the whole 8 hours of recording, although it was later on expelled naturally. In 21% of examinations the capsule didn't reach the caecum during the 8 hours of recording. We got a significant finding (multiple ulcers, bleeding, tumors, strictures, Crohn's disease) altogether in 50 % of patients. Of course in some patients we could also rule out significant small intestinal disease.As a conclusion capsule endoscopy is a safe procedure also in very young patients and it seems to be a very effective diagnostic tool in children with difficult GI symptoms and negative results in conventional endoscopic and radiologic examinations.