P293 Safety and diagnostic yield of wireless video capsule endoscopy in early onset inflammatory bowel disease (EOIBD) in children under the age of 6 years in a tertiary paediatric IBD centre

Abstract

Abstract Background Wireless video capsule endoscopy (VCE) is a well-established diagnostic tool used in the evaluation of small bowel disease in paediatric IBD. Patients usually swallow the capsule. Young children are rarely able to swallow the capsule and these therefore need to be placed with the help of an OGD and an ACORN device. 2 capsule systems were used: PillCam and MiroCam. The aim of this study was to look at the safety of capsule insertion in children less than 6 years of age and to also look at the diagnostic yield. Methods We conducted a retrospective review of our VCE data base over a 7 year period from April 2016 to August 2023. Results We conducted a retrospective review of our VCE data base over a 7 year period from April 2016 to August 2023. 22 patients (14 male) and 27 capsule episodes were included into the study with a an age range at point of capsule insertion between 2 years and 5 months and 5 years and 8 months (median 5 years). All capsules were inserted with an ACORN device. All patients had a histologically proven diagnosis of EOIBD; during this period 4 patients had 2 VCEs and 1 patient 3 VCEs placed. All patient had genetic tests performed, only 1/24 patients had a monogenic mutation confirmed. 15/27 (56%) of all capsules were normal, 8/27 (30%) showed small bowel ulcerations only, 2/27 (7%) showed both small bowel and colonic ulcerations and 5/27 (19%) showed colitis only. We were able to insert the capsule in all 27 capsule episodes without any complications. All studies were complete with the capsule entering the colon and no capsule got stuck. Conclusion Wireless video capsule endoscopy in early onset inflammatory bowel disease in children under the age of 6 years is safe with a diagnostic yield of around 50%. This modality should be used in the diagnostic pathway of EOIBD.