[Clinical application of wireless capsule endoscopy in pediatric and adolescent patients].
OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Ge
Zhi-zheng
ZZ
Department of Gastroenterology, Shanghai Institute of Digestive Disease, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200001, China.
Chen
Hai-ying
HY
Gao
Yun-jie
YJ
Gu
Jing-li
JL
Hu
Yun-biao
YB
Xiao
Shu-dong
SD
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D000293:Adolescent; D053704:Capsule Endoscopy / Q000009:adverse effects / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D012189:Retrospective Studies