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Wireless capsule endoscopy for pediatric small-bowel diseases.
Am J Gastroenterol. 2007 Aug; 102(8):1749-57; quiz 1748, 1758.AJ

Abstract

OBJECTIVE

Although capsule endoscopy (CE) is becoming an increasingly popular procedure, only recently data on its clinical application in pediatric gastroenterology are just emerging. Our aim is to investigate the diagnostic value of CE in small intestine diseases and to determine its safety, tolerance, and applicability in a large number of pediatric patients referred to our Tertiary Center of Pediatric Gastroenterology Unit, University of Parma.

METHODS

A total of 87 Italian patients, 49 of which were male with an age range from 18 months to 18 yr with a suspected small-bowel disease (inflammatory bowel disease 37%, polyps 38%, obscure gastrointestinal bleeding 24%, malabsorption 1%), were investigated with the M2A capsule (GIVEN((R)) Imaging Ltd., Yoqneam, Israel).

RESULTS

A total of 77 patients swallowed the capsule, while in 10 it was endoscopically positioned (age range 1.5-11 yr, median age 5.3 yr). Eighty patients naturally evacuated the capsule, one patient needed surgery. The capsule evidenced pathological findings in 62 patients (71%), ileal lymphoid nodular hyperplasia in four subjects (5%), it was negative in 18 subjects (21%), and technically failed in three subjects (3%). In 21 out of 28 patients with known polyposis and in all the five patients with suspected polyposis, small-bowel polyps were found. In 16 out of 22 patients suffering from known inflammatory bowel disease (Crohn's disease colitis or indeterminate colitis), small intestine lesions were found. CE examination identified a possible small intestine bleeding source in 13 out of 21 patients with suspected obscure gastrointestinal bleeding. In 5 out of 10 patients with suspected small-bowel inflammatory disease, CE evidenced ileum lesions suggesting Crohn's disease, which was subsequently confirmed through diagnostic procedures and the clinical history. A patient with malabsorption presented a negative capsule study.

CONCLUSIONS

Our experience, which includes the largest number of pediatric patients and the youngest child reported in literature, confirms that CE is a very useful system for the clinical work in suspected small-bowel diseases in infancy. The high rate of positive examination is due to the very careful selection of the patients, obligatory to conduct a safe examination since CE is not highly tested in children.

Authors+Show Affiliations

Pediatric Gastroenterologic Unit, University of Parma, Parma, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17686071

Citation

de' Angelis, Gian Luigi, et al. "Wireless Capsule Endoscopy for Pediatric Small-bowel Diseases." The American Journal of Gastroenterology, vol. 102, no. 8, 2007, pp. 1749-57; quiz 1748, 1758.
de' Angelis GL, Fornaroli F, de' Angelis N, et al. Wireless capsule endoscopy for pediatric small-bowel diseases. Am J Gastroenterol. 2007;102(8):1749-57; quiz 1748, 1758.
de' Angelis, G. L., Fornaroli, F., de' Angelis, N., Magiteri, B., & Bizzarri, B. (2007). Wireless capsule endoscopy for pediatric small-bowel diseases. The American Journal of Gastroenterology, 102(8), 1749-57; quiz 1748, 1758.
de' Angelis GL, et al. Wireless Capsule Endoscopy for Pediatric Small-bowel Diseases. Am J Gastroenterol. 2007;102(8):1749-57; quiz 1748, 1758. PubMed PMID: 17686071.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Wireless capsule endoscopy for pediatric small-bowel diseases. AU - de' Angelis,Gian Luigi, AU - Fornaroli,Fabiola, AU - de' Angelis,Nicola, AU - Magiteri,Barbara, AU - Bizzarri,Barbara, PY - 2007/8/10/pubmed PY - 2007/9/15/medline PY - 2007/8/10/entrez SP - 1749-57; quiz 1748, 1758 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 102 IS - 8 N2 - OBJECTIVE: Although capsule endoscopy (CE) is becoming an increasingly popular procedure, only recently data on its clinical application in pediatric gastroenterology are just emerging. Our aim is to investigate the diagnostic value of CE in small intestine diseases and to determine its safety, tolerance, and applicability in a large number of pediatric patients referred to our Tertiary Center of Pediatric Gastroenterology Unit, University of Parma. METHODS: A total of 87 Italian patients, 49 of which were male with an age range from 18 months to 18 yr with a suspected small-bowel disease (inflammatory bowel disease 37%, polyps 38%, obscure gastrointestinal bleeding 24%, malabsorption 1%), were investigated with the M2A capsule (GIVEN((R)) Imaging Ltd., Yoqneam, Israel). RESULTS: A total of 77 patients swallowed the capsule, while in 10 it was endoscopically positioned (age range 1.5-11 yr, median age 5.3 yr). Eighty patients naturally evacuated the capsule, one patient needed surgery. The capsule evidenced pathological findings in 62 patients (71%), ileal lymphoid nodular hyperplasia in four subjects (5%), it was negative in 18 subjects (21%), and technically failed in three subjects (3%). In 21 out of 28 patients with known polyposis and in all the five patients with suspected polyposis, small-bowel polyps were found. In 16 out of 22 patients suffering from known inflammatory bowel disease (Crohn's disease colitis or indeterminate colitis), small intestine lesions were found. CE examination identified a possible small intestine bleeding source in 13 out of 21 patients with suspected obscure gastrointestinal bleeding. In 5 out of 10 patients with suspected small-bowel inflammatory disease, CE evidenced ileum lesions suggesting Crohn's disease, which was subsequently confirmed through diagnostic procedures and the clinical history. A patient with malabsorption presented a negative capsule study. CONCLUSIONS: Our experience, which includes the largest number of pediatric patients and the youngest child reported in literature, confirms that CE is a very useful system for the clinical work in suspected small-bowel diseases in infancy. The high rate of positive examination is due to the very careful selection of the patients, obligatory to conduct a safe examination since CE is not highly tested in children. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/17686071/Wireless_capsule_endoscopy_for_pediatric_small_bowel_diseases_ DB - PRIME DP - Unbound Medicine ER -