Risk of capsule endoscope retention in pediatric patients: a large single-center experience and review of the literature.
OBJECTIVE
Capsule retention is a potential complication of capsule endoscopy (CE). The aims of our study were to determine the incidence of capsule retention in pediatric patients undergoing CE and to identify potential risk factors for capsule retention.


METHODS
We performed an institutional review board-approved retrospective chart review of pediatric patients undergoing CE studies at a single center. Data collected included patient age, sex, prior diagnosis of inflammatory bowel disease (IBD), CE indication, prior small bowel series results, study result, and complications.


RESULTS
Two hundred seven CE procedures were performed in pediatric patients during the study period. Capsule retention occurred in 3 (1.4%) of the 207 studies. All 3 patients had known Crohn disease (CD). The risk of capsule retention in pediatric patients with known IBD was 5.2% (3/58). The risk of capsule retention for patients with suspected IBD and all other indications was 0%. If small bowel disease was identified on upper gastrointestinal series in patients with known CD, then the risk of capsule retention was 37.5% (3/8). Only 7 patients with known IBD had a body mass index (BMI) below the 5th percentile. Of these 7 patients, 3 (43%) had capsule retention.


CONCLUSIONS
Red flags for potential CE retention identified in our study include known IBD (5.2% retention risk), previous small bowel follow-through demonstrating small bowel CD (37.5% retention risk), and BMI <5th percentile with known IBD (43% retention risk). Caution is advised in these pediatric patients before capsule ingestion.
Atay
Orhan
O
Department of Pediatric Gastroenterology, Cleveland Clinic Children's Hospital, Cleveland, OH 44195, USA.
Mahajan
Lori
L
Kay
Marsha
M
Mohr
Franziska
F
Kaplan
Barbara
B
Wyllie
Robert
R
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D053705:Capsule Endoscopes / Q000009:adverse effects*; D053704:Capsule Endoscopy / Q000009:adverse effects* / Q000379:methods; D002648:Child; D003424:Crohn Disease / Q000175:diagnosis; D004868:Equipment Failure; D005260:Female; D005547:Foreign Bodies / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis; D007421:Intestine, Small; D008297:Male; D012307:Risk Factors; D055815:Young Adult