title: Pediatric capsule endoscopy:  review of the small bowel and patency capsules.
abstract: OBJECTIVE
  Because capsule endoscopy (CE) avoids ionizing radiation, deep sedation, and general anesthesia, CE may be valuable in pediatrics. We report a single pediatric center's experience with the use and safety of CE.
  
  
  METHODS
  In a retrospective review of consecutive CE studies, 284 CE studies were performed in 277 patients with a mean age of 15 (±3.7) years during a 5-year period. The youngest to swallow the capsule was 4.6 years old. Twenty capsules were placed. Overall, 245 (86%) patients underwent CE for suspected (184, 65%) or confirmed (61, 21%) Crohn disease (CD); 27 (9.5%) anemia or gastrointestinal bleeding; 6 (2%) polyposis; and 4 (1.4%) celiac disease.
  
  
  RESULTS
  Positive findings were observed in 205 (72%) of the studies, with 152 (54%) having small bowel findings. Of these, 72 (47%) were diagnostic. Gastric (95, 33%) and colonic (31, 11%) abnormalities were also identified. Five CE studies (1.8%) resulted in retention of the capsule in nonsurgical patients. A patency capsule before CE in 23 patients allowed 19 CE to proceed with only 1 retained capsule. In 65 (21%) patients, the video capsule did not enter the colon before the video's end. Of these, 36 (65%) had significant findings, including 27 (49%) documenting small bowel (SB) CD.
  
  
  CONCLUSIONS
  CE is useful to diagnose SB disease in children. Even in a study population with a high prevalence of confirmed and suspected CD, the risk of retention remains small. The patency capsule may lessen that risk. CE may identify gastric or colonic disease even when SB lesions are not present.
authors.affiliation: Children's Healthcare of Atlanta, Atlanta, GA, USA. scohen@ccdhc.org
authors.forename: Stanley A
authors.initials: SA
authors.lastname: Cohen
authors.forename: Hagit
authors.initials: H
authors.lastname: Ephrath
authors.forename: Jeffery D
authors.initials: JD
authors.lastname: Lewis
authors.forename: Alan
authors.initials: A
authors.lastname: Klevens
authors.forename: Ari
authors.initials: A
authors.lastname: Bergwerk
authors.forename: Steven
authors.initials: S
authors.lastname: Liu
authors.forename: Dinesh
authors.initials: D
authors.lastname: Patel
authors.forename: Bonney
authors.initials: B
authors.lastname: Reed-Knight
authors.forename: Angela
authors.initials: A
authors.lastname: Stallworth
authors.forename: Tamara
authors.initials: T
authors.lastname: Wakhisi
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Gold
mesh_terms: D000293:Adolescent; D000740:Anemia / Q000473:pathology; D053705:Capsule Endoscopes; D053704:Capsule Endoscopy / Q000379:methods*; D002446:Celiac Disease / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000002:abnormalities / Q000473:pathology*; D003424:Crohn Disease / Q000473:pathology*; D005260:Female; D005547:Foreign Bodies; D005767:Gastrointestinal Diseases / Q000473:pathology*; D006471:Gastrointestinal Hemorrhage / Q000473:pathology; D006801:Humans; D007410:Intestinal Diseases / Q000473:pathology; D007415:Intestinal Obstruction; D044483:Intestinal Polyposis / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D012189:Retrospective Studies; D013270:Stomach / Q000002:abnormalities / Q000473:pathology*; D013272:Stomach Diseases / Q000473:pathology