The feasibility of wireless capsule endoscopy in detecting small intestinal pathology in children under the age of 8 years: a multicentre European study.

摘要

Objective: To systematically evaluate the feasibility andmethodology to carry out wireless capsule endoscopy(WCE) in children ,8 years to define small intestinalpathology.Design: Prospective European multicentre study withnegative prior investigation.Patients and interventions: 83 children aged 1.5–7.9 years were recruited. Initially, all were offered‘‘swallowing’’ (Group 1) for capsule introduction. If thisfailed endoscopic placement (Group 2) was used and theRoth net, Advance or custom-made introducers werecompared.Outcome measures: Primary endpoint: to determinepathology; secondary endpoint: comparison of capsuleintroduction methods.Results: Capsule introduction: 20 (24%) children aged4.0–7.9 years (mean, 6.9 years; 14 male) comprisingGroup 1 were older (p,0.025) than 63 (76%) aged 1.5–7.9 years (mean, 5.25 years; 30 male) forming Group 2.Complications: Roth net mucosal trauma in 50%; noothers occurred. The available recording apparatus wasinappropriate for those ,3 years. Indications: gastrointestinalbleeding: n=30 (16 positive findings: fourulcerative jejunitis, four polyps, two angiodysplasia, twoblue rubber blebs, two Meckel’s diverticula, oneanastomotic ulcer, one reduplication); suspected Crohn’sdisease: n=20 (11 had Crohn’s disease); abdominalpain: n=12 (six positive findings: three Crohn’s disease,two lymphonodular hyperplasia, one blue rubber bleb);protein loss: n=9 (four lymphangectasia); malabsorption:n=12 (seven positive findings: six enteropathy, oneascaris). No abnormalities overall: 45%.Conclusion: WCE is feasible and safe down to the age of1.5 years. 20 children .4 years swallowed the capsule.The Advance introducer proved superior for endoscopicplacement. The pathologies encountered showed agespecificity and, unlike in adolescents, obscure gastrointestinalbleeding was the commonest indication.