Faculty Collaboration Database

Capsule endoscopy performed across the pediatric age range: indications, incomplete studies, and utility in management of inflammatory bowel disease. Gastrointest Endosc 2010 Jul;72(1):95-102

Date

05/18/2010

Pubmed ID

20472231

DOI

10.1016/j.gie.2010.01.016

Scopus ID

2-s2.0-77954088319 (requires institutional sign-in at Scopus site)   48 Citations

Abstract

BACKGROUND: Capsule endoscopy (CE) is used increasingly to evaluate the small bowel in children. An upper GI series is recommended before CE to evaluate the risk of obstruction. Despite normal findings on an upper GI series, CE may still be incomplete. Although large adult studies have demonstrated the safety and diagnostic yield of CE, similar pediatric studies have not been available.

OBJECTIVE: To identify factors associated with incomplete studies and the diagnostic yield in pediatric patients.

DESIGN: Retrospective review of consecutive CE studies from February 2005 through June 2008.

SETTING: Large tertiary children's hospital.

PATIENTS: A total of 123 CE studies in 117 patients; median age 12.9 years (range 0.8-22.4 years).

MAIN OUTCOME MEASUREMENTS: Demographic information, indication, placement technique, pre-CE imaging results, and cecal completion status were recorded. Risk factors were analyzed with bivariate and multivariate regression analysis.

RESULTS: There were 27 (22%) incomplete studies; of these, there were normal pre-CE radiologic study findings in 12 (44%), and findings requiring medical, endoscopic, or operative intervention in 6. Of the 117 patients, CE produced a new diagnosis in 21 (18%). Abnormal findings on previous imaging (odds ratio [OR] 3.0; 95% CI, 1.2-8.0), endoscopic placement (OR 3.1; 95% CI, 1.1-8.4), and female sex (OR 3.3; 95% CI, 1.2-9.4) were associated with incomplete studies.

LIMITATIONS: Retrospective, incomplete follow-up.

CONCLUSIONS: CE may be performed in children as small as 11.5 kg, with 18% yield in all studies, and 28% in pediatric known inflammatory bowel disease. Capsule retention requiring retrieval did not pose life-threatening risk in our series, and CE may be used to identify disease-associated small-bowel stenosis.

Author List

Jensen MK, Tipnis NA, Bajorunaite R, Sheth MK, Sato TT, Noel RJ

Author

Ruta Brazauskas PhD Associate Professor in the Data Science Institute department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Capsule Endoscopy
Child
Child, Preschool
Colitis, Ulcerative
Crohn Disease
Device Removal
Equipment Failure
Female
Gastrointestinal Hemorrhage
Humans
Infant
Intestinal Obstruction
Lymphangioma
Male
Regression Analysis
Retrospective Studies
Risk Factors
Thrombocytopenia
Young Adult