title: The feasibility of wireless capsule endoscopy in detecting small intestinal pathology in children under the age of 8 years: a multicentre European study.
abstract: OBJECTIVE
  To systematically evaluate the feasibility and methodology to carry out wireless capsule endoscopy (WCE) in children <8 years to define small intestinal pathology.
  
  
  METHODS
  Prospective European multicentre study with negative prior investigation.
  
  
  METHODS
  83 children aged 1.5-7.9 years were recruited. Initially, all were offered "swallowing" (Group 1) for capsule introduction. If this failed endoscopic placement (Group 2) was used and the Roth net, Advance or custom-made introducers were compared.
  
  
  METHODS
  Primary endpoint: to determine pathology; secondary endpoint: comparison of capsule introduction methods.
  
  
  RESULTS
  Capsule introduction: 20 (24%) children aged 4.0-7.9 years (mean, 6.9 years; 14 male) comprising Group 1 were older (p<0.025) than 63 (76%) aged 1.5-7.9 years (mean, 5.25 years; 30 male) forming Group 2.
  
  
  RESULTS
  Roth net mucosal trauma in 50%; no others occurred. The available recording apparatus was inappropriate for those <3 years.
  
  
  METHODS
  gastrointestinal bleeding: n = 30 (16 positive findings: four ulcerative jejunitis, four polyps, two angiodysplasia, two blue rubber blebs, two Meckel's diverticula, one anastomotic ulcer, one reduplication); suspected Crohn's disease: n = 20 (11 had Crohn's disease); abdominal pain: 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, one ascaris). No abnormalities overall: 45%.
  
  
  CONCLUSIONS
  WCE is feasible and safe down to the age of 1.5 years. 20 children >4 years swallowed the capsule. The Advance introducer proved superior for endoscopic placement. The pathologies encountered showed age specificity and, unlike in adolescents, obscure gastrointestinal bleeding was the commonest indication.
authors.affiliation: Department of Gastroenterology, Homerton University Hospital, Homerton Row, London E9 6SR, UK. fri.rav@btopenworld.com
authors.forename: A
authors.initials: A
authors.lastname: Fritscher-Ravens
authors.forename: P
authors.initials: P
authors.lastname: Scherbakov
authors.forename: P
authors.initials: P
authors.lastname: Bufler
authors.forename: F
authors.initials: F
authors.lastname: Torroni
authors.forename: T
authors.initials: T
authors.lastname: Ruuska
authors.forename: H
authors.initials: H
authors.lastname: Nuutinen
authors.forename: M
authors.initials: M
authors.lastname: Thomson
authors.forename: M
authors.initials: M
authors.lastname: Tabbers
authors.forename: P
authors.initials: P
authors.lastname: Milla
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D016888:Angiodysplasia / Q000175:diagnosis*; D053704:Capsule Endoscopy / Q000009:adverse effects / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000175:diagnosis*; D005060:Europe; D005240:Feasibility Studies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007223:Infant; D008286:Malabsorption Syndromes / Q000209:etiology; D008297:Male; D008467:Meckel Diverticulum / Q000175:diagnosis*; D011504:Protein-Losing Enteropathies / Q000175:diagnosis; D016896:Treatment Outcome