Median Gastric Transit Time Research Articles

Efficacy and safety of capsule endoscopy in octogenarian patients: a retrospective study.

Life expectancy and the number of ultra-octogenarians increased significantly, thus making crucial the appropriateness of several endoscopic procedures in elderly patients. The aim of our study was to provide a retrospective analysis of the efficacy and safety of capsule endoscopy (CE) in patients aged over 80 years. In this single-centre study, 900 patients underwent capsule endoscopy between 2002 and 2015 for different indications; of these 106 patients aged ≥80 years (group A) and 99 patients aged 40-60 years (control group B) were retrospectively selected. Occult gastrointestinal bleeding accounted for 62.1% of all indications for capsule endoscopy in group B, compared to 95.2% in group A (P<0.001). Although not statistically significant, the diagnostic yield was higher in group A (71%) vs. group B (62%). The percentages of reaching the cecum and the median gastric transit time were uniform within the two groups. In contrast, small bowel transit time was longer in group A vs. B. Small bowel preparation was similar in the two groups. The exam was generally well tolerated in both groups, with capsule aspiration being one of the main adverse events, which occurred in two elderly patients. Our data expand previous findings confirming that capsule endoscopy can be performed safely even in very old patients and show that the diagnostic yield is similar to that of younger patients.

Utility of capsule endoscopy in the diagnosis of gastrointestinal graft-versus-host disease

Introduction and aimGraft-versus-host disease (GvHD) is a complication of hematopoietic cell transplantation, and the small bowel is one of the main targets in the gastrointestinal tract. Capsule endoscopy is a safe procedure and can be useful in the diagnosis of GvHD. The aim of the present study was to compare the diagnostic yield of capsule endoscopy with the histopathologic findings in GvHD. Materials and methodsA retrospective diagnostic test study included all the patients with suspected GvHD that underwent gastroscopy and colonoscopy, with histopathologic evaluation of the biopsies taken, and capsule endoscopy, within the time frame of July 2015 and July 2019. Capsule endoscopy findings were compared with the histopathologic diagnosis, considered the gold standard. ResultsTwenty-one patients with GvHD (7 [33%] women; 37 ± 11.9 years of age) were included, 20 (95%) of whom had acute GvHD. The median gastric transit time of the capsule was 55 minutes (20-113) and the median small bowel transit time was 261 minutes (238-434). The entire small bowel was visualized through capsule endoscopy in 17 cases (80.95%). The histopathologic findings and capsule endoscopy findings resulted in the diagnosis of GvHD in 17 and 16 cases, respectively. There was agreement between the histopathologic and capsule endoscopy findings in 18 cases (15 positive and 3 negative). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic yield of capsule endoscopy were 88%, 75%, 94%, 60%, and 85%, respectively. ConclusionsCapsule endoscopy is a safe tool for the diagnosis of GvHD, with high sensitivity and positive predictive value, as well as moderate agreement with histopathologic findings.

Can domperidone decrease transit time of pediatric video capsule endoscopy? A randomized controlled trial.

BackgroundThe complete examination rate of video capsule endoscopy can be increased by reduced gastric transit time (GTT) and or small bowel transit time (SBTT). This study aims to examine whether the prokinetic domperidone reduces GTT and/or SBTT in pediatric patients undergoing video capsule endoscopy (VCE).MethodsWe performed a single-center randomized controlled trial (n=200) to evaluate the effect of domperidone on GTT and SBTT among pediatric patients in a tertiary university-affiliated hospital for children. We explored whether patients randomized to domperidone had increased GTT, SBTT (primary outcomes) or higher complete examination rate (secondary outcome). The safety outcomes were the adverse effects in the domperidone group. This study was registered on ClinicalTrials.gov (NCT03662113).ResultsDemographic features including gender and age were similar between the 100 patients of the domperidone group and the 100 patients of the control group. The median GTT was 67.5 minutes (44.8–117.5) in the domperidone group and 80.0 minutes (42.0–128.0) in the control group, while the median SBTT was 317 minutes (231–436) and 323 minutes (225–426), respectively. There were no significant differences in GTT (P=0.49) and SBTT (P=0.52) between the two groups. The complete examination rate was 97% and 98% in the domperidone and control groups, respectively (P=1.00).ConclusionsDomperidone shows no effect on GTT, SBTT and complete examination rate in pediatric patients receiving VCE.

Utilidad de la cápsula endoscópica en el diagnóstico de la enfermedad injerto contra huésped gastrointestinal

Graft-versus-host disease (GvHD) is a complication of hematopoietic cell transplantation, and the small bowel is one of the main targets in the gastrointestinal tract. Capsule endoscopy is a safe procedure and can be useful in the diagnosis of GvHD. The aim of the present study was to compare the diagnostic yield of capsule endoscopy with the histopathologic findings in GvHD. A retrospective diagnostic test study included all the patients with suspected GvHD that underwent gastroscopy and colonoscopy, with histopathologic evaluation of the biopsies taken, and capsule endoscopy, within the time frame of July 2015 and July 2019. Capsule endoscopy findings were compared with the histopathologic diagnosis, considered the gold standard. Twenty-one patients with GvHD (7 [33%] women; 37±11.9 years of age) were included, 20 (95%) of whom had acute GvHD. The median gastric transit time of the capsule was 55minutes (20-113) and the median small bowel transit time was 261minutes (238-434). The entire small bowel was visualized through capsule endoscopy in 17 cases (80.95%). The histopathologic findings and capsule endoscopy findings resulted in the diagnosis of GvHD in 17 and 16 cases, respectively. There was agreement between the histopathologic and capsule endoscopy findings in 18 cases (15 positive and 3 negative). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic yield of capsule endoscopy were 88%, 75%, 94%, 60%, and 85%, respectively. Capsule endoscopy is a safe tool for the diagnosis of GvHD, with high sensitivity and positive predictive value, as well as moderate agreement with histopathologic findings.

Feasibility and safety of magnetically guided capsule endoscopy in minors

Objective: To clarify the feasibility and safety of magnetically guided capsule endoscopy (MGCE) in minors. Methods: A descriptive cohort study was carried out to retrospectively collect the data of minors (<18 years) who underwent MGCE in Ruijin Hospital from April 2015 to October 2018. Exclusion criteria: patients with dysphagia, obvious gastrointestinal bleeding, diagnosed or suspected gastrointestinal obstruction, or congenital gastrointestinal malformations or intestinal fistula; patients with previous bowel surgery, or in poor general condition; patients with implants; pregnant patients; patients with incomplete data or without data. A total of 218 patients, including 122 males and 96 females, with mean age of (12.0±3.1) (5-17) years and 236 times of examination were included. The capsule size of the Ankon MGCE system was 11.8 mm×27 mm, taking two pictures per second, with a viewing angle of 140 degrees. Data of gastric visualization (0% to 100%), gastric cleanliness (satisfactory cleanliness was defined as a clear display of the gastric mucosa; the effect of bubbles or mucus on the visual field was negligible, or the gastric mucosa was slightly blurred; a small amount of air bubbles or mucus affected slightly the field of view), gastric or small bowel examination time, lesion detection rate, etc. were recorded. All the patients were followed up for 2 weeks to confirm capsule excretion and to record adverse events. Results: A total of 202 patients (217 times) completed gastric examination and 112 patients (125 times) completed small bowel examination. The median gastric visualization of cardia, fundus, body, angulus, antrum and pylorus was 100%, 90% (75%,100%), 100% (80%,100%), 100%, 100%, and 100%, respectively. The cleanliness of the gastric cardia, fundus, body, angle, antrum, and pylorus was assessed to be satisfactory in 100.0%, 76.5% (153/200), 92.5% (185/200), 97.5% (195/200), 99.5% (199/200), and 100.0% of patients, respectively. In 202 patients undergoing gastric examination, the median gastric exanimation time was 10.5 (7.3, 13.9) minutes. In 112 patients undergoing small bowel examination, the median gastric transit time was 51.5 (20.6, 112.0) minutes and the median small bowel transit time was 232.4 (181.8, 321.6) minutes. The small bowel transit rate was 91.1% (102/112). The lesion detection rates of stomach, duodenum and jejunoileum were 18.8% (38/202), 8.1% (10/124) and 26.8% (30/112) respectively. No complications or adverse events occurred. Conclusion: MGCE is feasible and safe to detect both gastric cavity and small bowel in minors.

Association between hypokalemia and small bowel capsule endoscopy completion rates in patients in South China: A prospective single-center study.

Background/Aims:Approximately 20–30% of small bowel capsule endoscopies (SBCEs) do not reach the cecum at the completion of the examination. We aimed to determine whether hypokalemia influences the completion rate and small bowel transit time (SBTT) of SBCE.Patients and Methods:From January to December 2017, 112 patients (18–75 years old) who underwent SBCE were assessed consecutively for enrolment in our study. On the day of the procedure, a blood test was performed prior to capsule ingestion. The completion rate, gastric transit time (GTT), SBTT, and diagnostic yield were recorded for each SBCE.Results:The SBCE completion rate was lower in the hypokalemia group than that in the normal potassium group (55.6% (15/27) vs. 76.5% (65/85), P = 0.036). The median GTT was 55.5 ± 47.1 min in the hypokalemia group and 46.7 ± 44.5 min in the normal potassium group (P > 0.05). The median SBTT was 412.8 ± 123.3 min in the hypokalemia group and 367.3 ± 172.5 min in the normal potassium group (P > 0.05). The diagnostic yields of the hypokalemia and normal potassium groups were 74.1% and 78.8%, respectively (P = 1.00).Conclusion:Hypokalemia may decrease the SBCE completion rate. Physicians should consider the possibility of hypokalemia after bowel preparation because this condition is not rare. Potassium deficiencies should be rectified prior to performing SBCE procedures to increase the SBCE completion rate.

Sham Feeding with Bacon Does Not Alter Transit Time or Complete Examination Rate During Small Bowel Capsule Endoscopy.

During capsule endoscopy (CE) studies, the complete examination rate (CER) can be increased by prolonging capsule battery life or reducing gastric transit time (GTT) and/or small bowel transit time (SBTT). However, despite enhanced battery life, 10% of studies remain incomplete. Previously studied interventions to reduce SBTT and enhance CER have produced conflicting results. We hypothesize that this may be a consequence of an insufficiently potent stimulus of small bowel motility. To examine whether potent stimulation of the cephalic response of digestion during small bowel CE reduces GTT and/or SBTT and thus increases the CER. A single-blind randomized trial was performed to evaluate the effect of bacon sham feeding on GTT, SBTT and CER. Baseline characteristics were similar between 63 sham fed patients and 59 controls. The median GTT was 17min (9-65) in the bacon group and 25min (14-55) in the control group. The median SBTT was 199min (119-316) and 222min (151-287), respectively. Cox proportional hazards model demonstrated no significant difference between groups for GTT (rate ratio 1.03, 95% CI 0.71-1.51, P=0.87) or SBTT (rate ratio 1.02, 95% CI 0.70-1.49, P=0.93). Although the taste of bacon was considered favorably by 72% of participants, taste did not correlate with GTT (ρ=0.03, P=0.83) or SBTT (ρ=-0.115, P=0.33). The CER was 91 and 95% in the bacon and control groups, respectively (P=0.35). Bacon sham feeding has no effect on GTT, SBTT or CER and cannot be recommended in clinical practice.

Lubiprostone improves visualization of small bowel for capsule endoscopy: a double-blind, placebo-controlled 2-way crossover study.

Background and study aims Lubiprostone has been reported to be an anti-constipation drug. The aim of the study was to investigate the usefulness of lubiprostone both for bowel preparation and as a propulsive agent in small bowel endoscopy. Patients and methods This was a double-blind, placebo-controlled, 2-way crossover study of subjects who volunteered to undergo capsule endoscopy (CE). A total of 20 subjects (16 male and 4 female volunteers) were randomly assigned to receive a 24-μg tablet of lubiprostone 120 minutes prior to capsule ingestion for CE (L regimen), or a placebo tablet 120 minutes prior to capsule ingestion for CE (P regimen). Main outcome was gastric transit time (GTT) and small-bowel transit time (SBTT). Secondary outcome was adequacy of small-bowel cleansing and the fluid score in the small bowel. The quality of the capsule endoscopic images and fluid in the small bowel were assessed on 5-point scale. Results The capsule passed into the small bowel in all cases. Median GTT was 57.3 (3 – 221) minutes for the P regimen and 61.3 (10 – 218) minutes for the L regimen ( P = 0.836). Median SBTT was 245.0 (164 – 353) minutes for the P regimen and 228.05 (116 – 502) minutes for the L regimen ( P = 0.501). The image quality score in the small bowel was 3.05 ± 1.08 for the P regimen and 3.80 ± 0.49 for the L regimen ( P < 0.001). The fluid score in the small bowel was 2.04 ± 1.58 for the P regimen and 2.72 ± 1.43 for the L regimen ( P < 0.001). There was a significant difference between the 2 regimens with regard to image quality. The fluid score was more plentiful for the L regimen than for the P regimen. There were no cases of capsule retention or serious adverse events in this study. Conclusion Our study showed that use of lubiprostone prior to CE significantly improved visualization of the small bowel during CE as a result of inducing fluid secretion into the small bowel.

Video Capsule Endoscopy: A Tool for the Assessment of Small Bowel Transit Time.

Video capsule endoscopy (VCE) is a procedure that uses a wireless camera to take pictures of the gastrointestinal (GI) tract. A wireless motility capsule (WMC) of a similar size has been developed, which measures pH, pressure, and temperature and can be used to assess regional and total GI transit times. VCE could also potentially be used as a tool for measuring small bowel transit time (SBTT). This study was designed to obtain SBTT from VCE and compare it with historical data generated by WMC. Gastric transit time (GTT) was also measured. Patients were included if the indication for VCE was either iron deficiency anemia (IDA) or overt obscure GI bleed (OOGIB), and they did not have any known motility disorder. Results from VCE were also compared in diabetic vs. non-diabetic patients. There were a total of 147 VCE studies performed, including 42 for OOGIB and 105 for IDA. Median GTT and SBTT were 0.3 and 3.6 h, respectively. The overall median GTT and SBTT were 0.3 and 3.6 h, respectively, in the IDA group compared with 0.3 and 3.4 h in the OOGIB group. When compared with WMC, the GTT and SBTT were significantly faster in both groups (GTT: 3.6 h and SBTT: 4.6 h). The median GTT and SBTT were not significantly different in diabetics vs. non-diabetics [GTT: 17.5 vs. 18.0 min (P = 0.86) and SBTT: 3.9 h (237 min) vs. 3.8 h (230 min), respectively (P = 0.90)]. SBTT as measured using VCE is not significantly different in OOGIB compared with IDA. Both GTT and SBTT are significantly faster as assessed by VCE, which is initiated in the fasting state, compared with WMC measurement, which is initiated after a standard meal. In summary, VCE could potentially be used for measuring SBTT in the fasting state.

Video Capsule Endoscopy After Bariatric and Gastric Surgery

To investigate the outcomes of video capsule endoscopy (VCE) performed on patients after bariatric and gastric surgery with a focus on delivery method (oral ingestion or endoscopic placement). There is minimal published data regarding the use of VCE in patients after bariatric and gastric surgery and the optimal delivery method is unknown. Retrospective case series of patients with bariatric or gastric surgery undergoing VCE in a tertiary care center over 3 years. Outcomes of interest were completion of the procedure and bowel transit times. Twenty-three patients met study criteria. They underwent 24 VCE in the study period, with 13/16 (81.3%; 95% CI, 54%-96%) completed to the colon after oral ingestion and 5/8 (62.5%; 95% CI, 24%-91%) completed after endoscopic deployment. The median gastric transit time after oral ingestion was <1 minute (IQR, <1 to 99). Median total transit time after oral ingestion was 291 minutes (IQR, 213 to 434) and after endoscopic deployment was 364 minutes (IQR, 233 to >440) (P=0.48). There were no instances of capsule retention. Oral ingestion of VCE resulted in a satisfactory completion rate with rapid gastric transit after bariatric and gastric surgery. There were no capsule retention events. Given this and the favorable risk and cost profile, oral ingestion should be favored over endoscopic placement in this patient population.

PTH-141 Wireless Capsule Endoscopy – Diagnostic Yield And Clinical Utility Varies Widely According To Indication

IntroductionWireless capsule endoscopy (WCE) is a well established technique for imaging the small bowel, with an increasing clinical uptake and range of indications. We aimed to evaluate the utility of...

Video capsule endoscopy is successful and effective in outpatients with implantable cardiac devices

Implantable cardiac devices are a relative contraindication to video capsule endoscopy (VCE) because of concerns regarding interference. As a result of a lack of alternatives, some centers have adopted protocols to allow for VCE in these patients. There are minimal published descriptions of the gastrointestinal outcomes of these procedures. We investigated the completion rate and diagnostic yield of VCE carried out in outpatients with implantable cardiac devices. We carried out a retrospective review of all VCE from April 2010 through March 2013 at our center. Patients that underwent VCE through a specialized protocol for outpatients with implantable cardiac devices were identified. The protocol used telemetry for cardiac monitoring during battery lifespan of the VCE. Demographic data, procedure indications, results and any procedural events were collected. Twenty-one patients met the study criteria, with 16 (76%) pacemakers, four (19%) implantable cardioverter defibrilla tors and one (5%) implantable hemodynamic monitor. Two (10%) devices were adjusted prior to VCE. Twenty (95%) were completed to the colon, with a median gastric transit time of 18 min and a small bowel transit time of 216 min. The procedure was diagnostic in 13 (62%) patients. One (5%) capsule retention event occurred. No cardiac events or video capture disturbances occurred. Video capsule endoscopy done on outpatients with implantable cardiac devices through a cardiac monitoring protocol resulted in a satisfactory completion rate and high diagnostic yield with no adverse cardiac events. A large prospective trial is needed to confirm these novel results.

Opioid Use Is Associated with Prolonged Gastric Transit Time in Hospitalized Patients Receiving Video Capsule Endoscopy

Purpose: To investigate the effect of opioids on bowel transit time and completion rate in hospitalized patients undergoing video capsule endoscopy (VCE). Methods: We performed a retrospective review of all hospitalized patients undergoing VCE since the implementation of a new electronic medical record (October 15, 2011 - March 31, 2013). Exclusion criteria included endoscopic placement. Demographic data, medical history, medications and indication for VCE were collected from the medical record. Gastric transit time (GTT), small bowel transit time, total transit time (TTT) and study completion were collected from the VCE report. Transit times were summarized using median and inter-quartile range (IQR) and compared by log-rank analysis. Multivariable logistic regression modeling was utilized with resultant odds ratios (OR) and 95% confidence intervals (95% CI). Results: We performed 157 VCE that met study criteria. Patients without opioids within 48 hours of the VCE had a median GTT of 12 min, IQR 7 - 35 and patients with opioids within 48 hours had a median GTT of 42 min, IQR 12 - 87 (p=0.007). Patients without opioid use were also less likely to have a GTT > 45 min (22% vs. 46%, p= 0.005). There was a trend toward lower total transit times (TTT) in patients not receiving opioids, with a median TTT of 246 min, IQR 189 - 362 compared to 286 min, IQR 212 - > 480 in the opioids group (p= 0.13). There was not a significant difference in VCE completion rate (82% vs. 74%, p=0.28) or gastric capsule retention (2% vs. 5%, p=0.67) between the groups. Demographic data and medical history were similar. After multivariable logistic regression modeling, opioid use was associated with GTT > 45 min (OR 2.96, 95% CI 1.33, 6.61, p=0.008). Conclusion: Opioid use within 48 hours of VCE was significantly associated with prolonged GTT in hospitalized patients. We also found a significant increase in GTT > 45 minutes with opioid use, a benchmark that has been associated with incomplete VCE in previous studies. Although we did not find a significant difference in completion rate with opioid use (perhaps related to sample size), we noted a trend toward longer TTT. This data suggests hospitalized patients should avoid opioids during the 48 hours prior to VCE ingestion to decrease incidence of prolonged GTT.

PTU-043 Diagnostic Yield and Safety of Small Bowel Capsule Endoscopy

IntroductionSmall bowel capsule endoscopy (CE) is a minimally-invasive, established tool for the detection of small bowel lesions.MethodsAll capsule endoscopy reports from Jan 2007 to Aug 2012 performed at the Royal...

PTU-022 Domperidone improves Completion Rate in small Bowel Capsule Endoscopy

IntroductionThe completion rate of small bowel capsule endoscopy (SBCE) has been reported as 81.3–84.8%.1 Aside lumenal narrowing, incomplete SBCE can be due to delayed gastric emptying, intestinal dysmotility and/or capsule...

The Effect of Metoclopramide in Capsule Enteroscopy

Clinical utility of prokinetics in capsule endoscopy (CE) is not clearly established. The objective of this prospective, randomized, single-blind, controlled trial was to determine if metoclopramide is useful in CE by increasing the rate of complete enteroscopy. Ninety-five patients referred for CE were randomized to no metoclopramide (group B, n = 48) or 10 mg metoclopramide (group A, n = 47). Complete enteroscopy was possible in 38 patients of group A (80.9%) and 37 of group B (77.1%) (P = 0.422) with two cases of gastric retention in group B (4.2%; P = 0.253). Median gastric transit time was 26 min (1-211) in group A and 28 min (4-200) in group B (P = 0.511). Mean small bowel transit time, calculated after excluding 20 patients with incomplete enteroscopy, was similar in both groups (221.2 +/- 89 min vs. 256 +/- 82.2 min; P = 0.083). There were also no differences in the total number of findings (group A 4.5 +/- 4.7; group B 4.7 +/- 3.7, P = 0.815). Administration of 10 mg metoclopramide orally 15 min before capsule ingestion did not significantly increase the rate of total enteroscopies and had no effect on transit times. It also did not modify CE diagnostic yield.

Clinical impact of a newly developed capsule endoscope: usefulness of a real-time image viewer for gastric transit abnormality

A new capsule endoscope has been developed by Olympus Medical Systems. The visualization and usefulness of its real-time image viewer for gastric transit abnormality were evaluated by using this new device. Thirty-seven consecutive patients were enrolled. In cases of gastric transit abnormality (gastric transit > 60 min, detected by the real-time viewer), intramuscular metoclopramide (10 mg) was administered. Diagnostic yield and gastric and small bowel transit times in ten patients receiving (group A) and 27 not receiving (group B) metoclopramide were analyzed. Median gastric transit time was longer in group A than in group B (110 vs. 24 min; P < 0.0001). Conversely, median small bowel transit time was shorter in group A than in group B (270 vs. 347 min; P < 0.05). Further, small bowel transit was complete in 9/10 patients (90%) in group A, and in 23/27 patients (85%) in group B, but the difference was not significant. Overall diagnostic yield was 78% (29/37 patients), and there was no significant difference in the ratio of abnormal findings documented between group A (8/10, 80%) and group B (21/27, 78%) patients. This new technology allowed clear image interpretation, and the real-time viewer was useful for detecting gastric transit abnormalities and determining a need for metoclopramide administration in patients undergoing capsule endoscopy.

Clinical application of wireless capsule endoscopy in pediatric patients for suspected small bowel diseases

Capsule endoscopy (CE) has been demonstrated to be safe and well tolerated in adults with suspicion of small intestinal diseases with negative results of gastroscopy and colonoscopy. However, its value in pediatric patients has not yet been well studied. This study aimed to evaluate the results and safety of CE in pediatric patients with suspicion of small bowel disorders. There were 16 consecutive children and adolescents (12 boys, 4 girls) and 15 adults (9 men, 6 women) referred to us for suspected small bowel diseases from August 2002 to September 2005. Among the pediatrics, six patients were less than 10 years old. Technique for capsule placement, gastric transit time, small bowel transit time, excretion time of capsule endoscopy, capsule findings, and complications were recorded. All 16 pediatric patients described that the capsule was easy to swallow except for three children. Finally we delivered the capsule under gastroscopy with overtube for these three children. No capsule retention occurred during our study. Median recording time was 7 h 44 min (range 6 h 51 min-9 h 11 min). Median gastric transit time was 83.5 min (range 4-296 min). Median small bowel transit time was 270 min (range 142-484 min). Median excretion time of capsule was 33.9 h (range 12-96 h). There was no significant difference in excretion time of capsule, gastric transit time and small bowel transit time between pediatric patients and adult patients (P > 0.05). CE was positive in 12 patients, including Crohn's disease (4), hemangioma (2), angiodysplasia (2), Meckel diverticulum (1), polyp (1), aphthous ulcer in ascending colon (1), and cobblestone appearance of ileal mucosa. CE has been performed safely in a small series of pediatric patients after ingestion or endoscopic placement of the capsule. The high yield of abnormal findings was comparable to those of adult patients.

Clinical application of wireless capsule endoscopy in pediatric and adolescent patients

Capsule endoscopy (CE) has been demonstrated to be safe and well tolerated in adults. However, its value in pediatric patients has not been well studied. The present study aimed to evaluate the safety and effectiveness of CE in pediatric patients with suspicious small bowel disorders. Fifteen children and adolescents (less than 18 years) were referred to our study for suspected small bowel diseases from Aug. 2002 to May 2005. They aged from 3 to 18 years. Among them, 5 patients were less than 10 years old. The range of weight was from 17 to 83 kg and height was from 49 to 176 cm. Clinical indications included obscure gastrointestinal bleeding (n = 12) and abdominal pain (n = 3). All the patients had normal results on upper and lower gastrointestinal examinations before they underwent CE. The procedures for capsule placement, gastric transit time, small bowel transit time, the average time of the elimination of the capsule, capsule findings, and complications were recorded. All the patients described that the capsule was easy to swallow except 3 youngest children. Finally the capsule was delivered via gastroscopy with overtube for these three children under intravenous anesthesia. No capsule retention occurred during the study. Median recording time was (464 +/- 40) min. In 5 patients, the capsule did not pass the ileal valve by the end of the recording time. Median gastric transit time was (85 +/- 90) min. Median small bowel transit time was (283 +/- 106) min. The average time of the elimination of the capsule was (34.3 +/- 21.8) h. The detective yield of CE was 80%. These positive findings included Crohn's disease (5), hemangioma (2), angiodysplasia (2), Meckel diverticulum (1), polyp (1), and granulomatous lesions (1). CE was performed safely in pediatric patients after ingestion or endoscopic placement of the capsule. The high yield of abnormal findings was comparable to those of adult patients.

Endoscopic Placement of the Video Capsule with the AdvanCE™ Delivery Device

Background: Capsule endoscopy (CE) has been demonstrated to be safe and well tolerated in adults. However, its value in pediatric patients hasn’t been well studied yet. Methods: There were 15 children and adolescents (less than 18 years) referred to our study for suspected small bowel diseases from Aug 2002 to May 2005. Median age was 12 years old (range: 3-18 years). Among them, 5 patients were less than 10 years old. Median weight was 43.5 kg (range: 17-83 kg). Median height was 143.4 cm (range: 49-176 cm). Clinical indications included obscure gastrointestinal bleeding (12) and abdominal pain (3). All the patients had normal results in upper and lower gastrointestinal examinations before they undergone CE. Technique for capsule placement, gastric transit time, small bowel transit time, the average time of the elimination of the capsule, capsule findings, and complications were recorded. Results: All patients described that the capsule was easy to swallow except 3 youngest children. Finally we delivered the capsule under gastroscopy with overtube for these three children. No capsule retention occurred during our study. Median recording time was 7 h 44 min (range: 6 h 51min-9 h 11 min). In 5 patients (33.3%), the capsule did not pass the ileal valve by the end of the recording time. Median gastric transit time was 85 min (range: 4-296 min). Median small bowel transit time was 283 min (range: 142-484 min). The average time of the elimination of the capsule was 34.3 h (range 12-96 h). The detective yield of CE was 80%. Conclusion: CE has been performed safely in pediatric patients after ingestion or endoscopic placement of the capsule. The high yield of abnormal findings was comparable to those of adult patients.