Usefulness of Capsule Endoscopy and Double Balloon Enteroscopy in Juvenile Patients

Abstract

Background/Objective: Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) have been introduced as modalities for examining the entire small bowel. There had been very few report on the special characteristics of small bowel disease in juvenile patients. The aim of this study is to evaluate both characteristics of small bowel disease and usefulness of CE and DBE in juveniles. Methods: From August 2003 through June 2007, CE (PillCamTMSB, Given Imaging Ltd. Israel) and/or DBE (EN-450P5, EN-450T5, Fujinon Co., Saitama, Japan) was performed in 16 juvenile patients suspicious of small bowel disease (7 male, 9 female; mean age 19.3 years, range 11-22 years). Twelve of 16 patients underwent CE whereas 9 patients did DBE, that is, 5 patients had both exam. Results: The reasons for the study were gastrointestinal bleeding (n = 7), multiple colon polyps(n = 4), unexplained abdominal pain (n = 3), and chronic diarrhea(n = 2). Small bowel abnormalities were detected using CE in 7 (58%) of the 12 patients and in 7 (78%) of the 9 patients using DBE.(Table). Among the 5 patients performed with both examination, 2 patients had small bowel ulcers and 1 patient showed no abnormality with both examination. One patient had small bowel erosion detected only in CE finding and another patient had vascular malformation was seen only in DBE. The final diagnosis of 16 patients were made as small bowel erosion or ulcers (n = 4), Peutz-Jegher syndrome (n = 2), Crohn's disease (n = 2), hyperplastic polyposis (n = 2), vascular malformation(n = 2) and peri-appendiceal abscess (n = 1). Other three patients did not have any abnormalities in both exams. There were no any serious complications including bleeding, retention or perforation. Conclusion: Similar to pattern in adults, Our study showed various small bowel disease in juvenile patients suggesting CE and DBE as useful and well-tolerated method with a high diagnostic yield for the management of suspected small bowel disease in juveniles. Tabled 1Endoscopic findings Erosion or ulcer Polyp Lymphoid hyperplasia Angiodysplasia Ileal edema & extrinsic compression Nonspecific finding CE (N = 12) 4 1 1 1 0 5 DBE (N = 9) 4 1 0 1 1 2 Open table in a new tab