Video capsule endoscopy in pediatric patients with Crohn’s disease: a single-center experience of 180 procedures

Author:

Nemeth Artur1,Agardh Daniel2,Wurm Johansson Gabriele1,Thorlacius Henrik3,Toth Ervin4ORCID

Affiliation:

1. Department of Gastroenterology, Skåne University Hospital, Lund University, Malmö, Sweden

2. Department of Pediatrics, Skåne University Hospital, Lund University, Malmö, Sweden

3. Department of Surgery, Skåne University Hospital, Lund University, Malmö, Sweden

4. Endoscopy Unit, Department of Gastroenterology, Skåne University Hospital, Lund University, Getg, 40, S-205 02 Malmö, Sweden

Abstract

Background Video capsule endoscopy (VCE) is a noninvasive method enabling excellent visualization of the small bowel (SB) mucosa. The aim of this study was to examine the impact and safety of VCE performed in children and adolescents with suspected or established Crohn’s disease (CD). Methods A total of 180 VCE examinations in 169 consecutive patients conducted in 2003–14 in a single center were retrospectively analyzed. The median age was 13 years (range 3–17 years) and indications for VCE were suspected (125 cases, 69%) and established (55 cases, 31%) CD. VCE was performed with a PillCam SB (Given Imaging, Yokneam, Israel) VCE system with 8–12 h of registration without bowel preparation. Results A total of 154 of 180 (86%) patients swallowed the capsule and 26 (14%) had the capsule endoscopically placed in the duodenum. Patency capsule examination was performed in 71 cases prior to VCE to exclude SB obstruction. VCE detected findings consistent with SB CD in 71 (40%) examinations and 17 (9%) procedures showed minor changes not diagnostic for CD. A total of 92 (51%) examinations displayed normal SB mucosa. The capsule did not reach the colon within the recording time in 30 (17%) procedures and were defined as incomplete examinations. A change in diagnosis or therapy was recommended in 56 (31%) patients based on VCE results. Capsule retention occurred in one patient. Conclusions VCE is a safe method in children with suspected or established CD. VCE often leads to a definitive diagnosis and has a significant impact on the clinical management of pediatric patients with CD.

Funder

A Nemeth received grant for PhD students from Region Skane

Publisher

SAGE Publications

Subject

Gastroenterology

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