Wireless Capsule Endoscopy in Pediatric Gastrointestinal Diseases

Abstract

Capsule endoscopy (CE), which was invented to visualize the entire small intestine in a noninvasive manner was first described in 2000 (Iddan, 2000), was approved for adult patients in 2001 by Food and Drug Administration (FDA). More than 600,000 PillCam SB capsules, which is the first model for CE in the world, have been used worldwide since 2001 (Nakamura, 2009). In pediatric patients, Seidman et al has first described the diagnostic value of CE (Seidman, 2002), and in 2003, FDA approved CE for pediatric patients ages 10 years and older. Emerging number of CE studies in children indicate the great demand for this population ( Tokuhara, 2010; de'Angelis, 2007; Atay, 2009; Fritscher-Ravens, 2009; Moy, 2009; Guilhon de Araujo Sant'Anna, 2005; Thomson, 2010; Ge, 2007; Postgate, 2009; Pinho, 2008; Shamir, 2007; Stiffler, 2003; Arguelles-Arias, 2004; Cohen, 2008 ), but performed number is relatively small (approximately 600, at the time of 2010) compared to adult cases (> 600,000), therefore, informations about indications, obtained results and risk of complications are not fully understood in pediatric patients. In pediatric patients, as well as in adults, CE is a firstline of examination to evaluate the entire small intestine and provides evidence for the diagnosis to the suspected small bowel disease especially in obscure gastrointestinal bleeding (OGIB) and suspected inflammatory bowel disease (IBD), on the other hand, accumulated studies are extending the indication of CE to protein loss, growth failure, abdominal pain, suspected polyp or graft-versus-host disease (GVHD) and regular follow-up for the known small bowel diseases. In this review, we summarize and discuss the capsule endoscopy system, indication, limitation, and future perspective of CE in pediatric patients.