Wireless video capsule in pediatric patients with functional abdominal pain.
OBJECTIVE
Upper endoscopy (esophagogastroduodenoscopy [EGD]) has a limited role, if any, in the evaluation of functional abdominal pain (FAP). Nevertheless, children with intractable FAP are occasionally referred to EGD to rule out intestinal pathology. We evaluated the role of wireless video capsule endoscopy (VCE) in children referred for EGD with a diagnosis of FAP.


METHODS
Ten children older than 10 years of age were prospectively enrolled. Children were first studied with the PillCam SB (VCE; Given Imaging, Yokneam, Israel) followed by standard EGD within 2 weeks. After the completion of the study, a questionnaire of tolerance and content regarding the 2 procedures was completed by the patients.


RESULTS
Physical examinations and laboratory tests were within normal limits in all of the patients. Patients swallowed the endoscopic capsules without difficulty. There were no complications. VCE identified gastritis in 4 patients (confirmed by biopsies), whereas EGD detected erosive gastritis in only 1 of the 4 children. EGD detected no duodenal abnormalities. VCE detected Crohn disease in the small intestine and cecum in 1 patient. VCE was ranked by 8 patients as convenient and as a preferable procedure compared with EGD.


CONCLUSIONS
The results of this small cohort suggest that in children with FAP, VCE is more sensitive than EGD for detection of macroscopic gastric and small bowel pathologies.
Shamir
R
R
Division of Pediatric Gastroenterology and Nutrition, Meyer Children's Hospital of Haifa, Haifa, Israel. shamirr@netvision.net.il
Hino
B
B
Hartman
C
C
Berkowitz
D
D
Eshach-Adiv
O
O
Eliakim
R
R
D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D053704:Capsule Endoscopy; D002648:Child; D016145:Endoscopy, Digestive System; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies