[Capsule endoscopy in children: which are the best indications?].
OBJECTIVE
Capsule endoscopy (CE) is a novel and noninvasive means of investigating the small bowel. In children, the best CE indications have not yet been fully appraised. The aim of this study was to evaluate the diagnostic yield of CE in different pediatric pathologies.


METHODS
We retrospectively reviewed every CE performed in children in two French pediatric hospitals between March 2002 and June 2009. Seventy-nine CEs were performed on 70 children (mean age, 10.6 years; range, 2.2-18.0); 52 boys and 18 girls. The indications were iron deficiency anemia (24%), obscure gastrointestinal bleeding (14%), polyposis syndromes (16%), suspected Crohn disease (15%), unresponsive Crohn disease (10%), graft-versus-host disease (10%), and other (10%).


RESULTS
Of the 79 CEs, 69 reached the cecum (87%). Only one occlusion occurred in a case of stenosing Crohn disease, requiring surgical removal. In addition, technical difficulties led to an incomplete small bowel study in 12 cases (16%). The CE showed small bowel lesions in 42 cases (53%). The diagnostic yield was 27% in obscure gastrointestinal bleeding, 37% in iron-deficiency anemia, 42% in suspected Crohn disease, 88% in unresponsive Crohn disease, 62% in polyposis syndromes, and 88% in graft-versus-host disease.


CONCLUSIONS
In children, CE is well tolerated and can be performed in children as young as 2.2 years of age. Its diagnostic yield is highest in polyposis syndromes, unresponsive Crohn disease, and graft-versus-host disease.
Dupont-Lucas
C
C
Service de pédiatrie, hôpital Femme-Enfant-Hématologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 09, France. dupont-c@chu-caen.fr
Bellaïche
M
M
Mouterde
O
O
Bernard
O
O
Besnard
M
M
Campeotto
F
F
Languepin
J
J
Mosca
A
A
Goulet
O
O
Vannerom
P-Y
PY
Mougenot
J-F
JF
Cardey
J
J
Cézard
J-P
JP
Viala
J
J
D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis; D053704:Capsule Endoscopy / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005602:France; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis; D006086:Graft vs Host Disease / Q000175:diagnosis; D006776:Hospitals, Pediatric; D006801:Humans; D044483:Intestinal Polyposis / Q000175:diagnosis; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity