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Endoscopy 2004; 36(10): 869-873
DOI: 10.1055/s-2004-825854
Original Article
© Georg Thieme Verlag Stuttgart · New York

The Value of Capsule Endoscopy in Pediatric Patients with a Suspicion of Crohn’s Disease

F.  Argüelles-Arias1 , A.  Caunedo1 , J.  Romero1 , A.  Sánchez1 , M.  Rodríguez-Téllez1 , F.  J.  Pellicer1 , F.  Argüelles-Martín2 , J.  M.  Herrerías1
  • 1Gastroenterology Service, Virgen Macarena University Hospital, Seville, Spain
  • 2Dept. of Pediatric Gastroenterology, Virgen Macarena University Hospital, Seville, Spain
Further Information

Publication History

Submitted 29 December 2003

Accepted after Revision 15 June 2004

Publication Date:
28 September 2004 (online)

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Background and Study Aims: The aim of this study was to assess the safety and usefulness of capsule endoscopy (CE) in pediatric patients with a suspicion of Crohn’s disease.
Patients and Methods: CE was used in 12 patients (four girls, eight boys; age 12 - 16; weight range 43 - 87 kg). The indication was a clinical suspicion of Crohn’s disease not confirmed with traditional methods. Gastroscopy, colonoscopy, and small-bowel follow-through examinations were carried out in all of the patients, without any diagnostic findings. Ileoscopy was possible in 50 % of the patients, and the ileal mucosa and biopsies were normal in all cases.

Results: The capsule was easily swallowed by all of the patients. They all excreted the capsule normally, and no complications were observed in any case. CE identified lesions suggestive of Crohn’s disease in seven of the 12 (58.3 %), and the majority of the lesions were in the ileum.
Conclusions: CE is safe in pediatric patients over 12 years of age. The procedure appears to be a very useful diagnostic tool in children with Crohn’s disease.

References

  • 1 Maglinte D, Kelvin F, O’Connor K. et al . Current status of small bowel radiography.  Abdom Imaging. 1996;  21 247-257
    CrossrefPubMedSearch in Google Scholar
  • 2 Lewis B S. Radiology versus endoscopy of the small bowel.  Gastrointest Endosc Clin N Am. 1999;  9 13-27
    PubMedSearch in Google Scholar
  • 3 Rossini F P, Pennazio M. Small-bowel endoscopy.  Endoscopy. 2002;  34 13-20
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy.  Nature. 2000;  405 417
    PubMedSearch in Google Scholar
  • 5 Costamagna G, Shah S K, Riccioni M E. et al . A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease.  Gastroenterology. 2002;  123 999-1005
    CrossrefPubMedSearch in Google Scholar
  • 6 Scapa E, Jacob H, Lewkowicz S. et al . Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology.  Am J Gastroenterol. 2002;  97 2776-2779
    CrossrefPubMedSearch in Google Scholar
  • 7 Ell C, Remke S, May A. et al . The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding.  Endoscopy. 2002;  34 685-689
    Search in Google Scholar
  • 8 Lewis B S, Swain P. Capsule endoscopy in the evaluation of patients with suspected small intestinal bleeding: results of a pilot study.  Gastrointest Endosc. 2002;  56 349-353
    Search in Google Scholar
  • 9 Saurin J C, Delvaux M, Gaudin J L. et al . Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy.  Endoscopy. 2003;  35 576-584
    Search in Google Scholar
  • 10 Hartmann D, Schilling D, Bolz G. et al . Capsule endoscopy versus push enteroscopy in patients with occult gastrointestinal bleeding.  Z Gastroenterol. 2003;  41 377-382
    Search in Google Scholar
  • 11 Lewis B. Enteroscopy: endangered by the capsule?.  Endoscopy. 2002;  34 416-417
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Caunedo-Álvarez A, Rodríguez-Téllez M, Barroso-Relinque N. et al . Role of capsule endoscopy in the management of patients with obscure gastrointestinal bleeding.  Rev Esp Enferm Dig. 2002;  94 482-488
    PubMedSearch in Google Scholar
  • 13 Fireman Z, Mahajna E, Broide E. et al . Diagnosing small bowel Crohn’s disease with wireless capsule endoscopy.  Gut. 2003;  52 390-392
    Search in Google Scholar
  • 14 Eliakim R, Fischer D, Suissa A. et al . Wireless capsule endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn’s disease.  Eur J Gastroenterol Hepatol. 2003;  15 363-367
    Search in Google Scholar
  • 15 Herrerias J M, Caunedo A, Rodriguez-Tellez M. et al . Capsule endoscopy in patients with suspected Crohn’s disease and negative endoscopy.  Endoscopy. 2003;  35 564-568
    Search in Google Scholar
  • 16 Argüelles-Arias F, Argüelles-Martín F, Caunedo A. et al . Usefulness of capsule endoscopy in pediatric patients [abstract].  J Pediatr Gastroenterol Nutr. 2003;  36 544
    PubMedSearch in Google Scholar
  • 17 Furman M, Mylonaki M, Fritscher-Ravens A. et al . Wireless capsule endoscopy in small bowel disease in pediatrics: a study to assess the diagnostic yield [abstract].  J Pediatr Gastroenterol Nutr. 2003;  36 544
    PubMedSearch in Google Scholar
  • 18 Seidman E, Sant’Anna A, Dubois J. et al .Capsule video-endoscopy in children reveals occult small bowel disorders. Abstract presented at a conference on capsule endoscopy,. Rome; 17 - 19 March 2002
    Search in Google Scholar
  • 19 Sant’Anna A MG, Miron M C, Dubois J. et al . Wireless capsule endoscopy for obscure small bowel disorders: final results of the first pediatric trial [abstract].  Gastroenterology. 2003;  124 A 17
    PubMedSearch in Google Scholar
  • 20 Vodelholzer W A, Ortner M, Rogalla P. et al . Diagnostic yield of wireless capsule enteroscopy in comparison with computed tomography enteroclysis.  Endoscopy. 2003;  35 1009-1014
    Thieme ConnectPubMedSearch in Google Scholar
  • 21 Argüelles-Arias F, Argüelles-Martín F, Caunedo A. et al . Utilidad de la cápsula endoscópica en gastroenterología pediátrica.  An Pediatr (Barc). 2003;  59 586-589
    CrossrefPubMedSearch in Google Scholar
  • 22 Aabakkken L, Scholz T, Ostenten A B. et al . Capsule endoscopy is feasible in small children.  Endoscopy. 2003;  35 798
    Thieme ConnectPubMedSearch in Google Scholar
  • 23 Chong A KH, Taylor A CF, Miller A M, Desmond P V. Initial experience with capsule endoscopy at a major referral hospital.  Med J Aust. 2003;  178 537-540
    PubMedSearch in Google Scholar
  • 24 Caunedo A, Rodríguez-Téllez M, Romero R. et al .Utility of capsule endoscopy in patients with suspicion of small-bowel disease (our first year’s experience). Paper presented at the Second Given Conference on Capsule Endoscopy,. Berlin; 23 - 24 March 2003
    Search in Google Scholar
  • 25 Cave D R. Wireless video capsule endoscopy.  Clin Perspect Gastroenterol. 2002;  5 203-207
    PubMedSearch in Google Scholar
  • 26 Bhinder F, Schneider D R, Farris K. et al . NSAID-associated small intestinal ulcers and strictures: diagnosis by video capsule endoscopy [abstract].  Gastroenterology. 2002;  122 (Suppl) A 345
    PubMedSearch in Google Scholar
  • 27 Jonnalagadda S, Prakash C. Intestinal strictures can impede wireless capsule enteroscopy.  Gastrointest Endosc. 2003;  57 418-420
    CrossrefPubMedSearch in Google Scholar
  • 28 De Franchis R, Avesani E M, Abbiati C. et al . Unsuspected ileal stenosis causing obscure GI bleeding in patients with previous abdominal surgery - diagnosis by capsule endoscopy: a report of two cases.  Dig Liver Dis. 2003;  35 577-584
    CrossrefPubMedSearch in Google Scholar
  • 29 Sant’Anna A MG, Miron M C, Dubois J. et al . Wireless capsule endoscopy for obscure small bowel disorders: final results of the first pediatric trial [abstract].  Gastroenterology. 2003;  124 A 17
    PubMedSearch in Google Scholar
  • 30 Furman M A, Mylonaki M, Fritscher-Ravens A. et al . Wireless capsule endoscopy in children: a study to assess the diagnostic yield in small-bowel disease in pediatric patients [abstract].  Gastrointest Endosc. 2003;  57 AB 89
    PubMedSearch in Google Scholar

J. M. Herrerías, M. D.

Gastroenterology Service, Virgen Macarena University Hospital

Avenida Dr. Fedriani · 41071 Seville · Spain

Fax: +34-95-500 8805

Email: jmhg@us.es