Capsule endoscopy followed by single balloon enteroscopy in children with obscure gastrointestinal bleeding: A combined approach

Oliva, Salvatore; Pennazio, Marco; Cohen, Stanley A.; Aloi, Marina; Barabino, A.; Hassan, Cesare; Pession, Andrea; Lima, Mario; Frediani, Simone; Nardo, Giovanni Di

doi:10.1016/j.dld.2014.09.001

Cited by 35 publications

(26 citation statements)

References 30 publications

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“…The main symptom in the present case was hematochezia. An AVM might be an important cause of GI bleeding because a previous study showed that doubleballoon or capsule endoscopy revealed an AVM in 6.3 to 18.1% of children with occult GI bleeding who underwent examinations by double-balloon endoscopy or capsule endoscopy [13,14]. AVMs also cause wideranging clinical problems such as bowel atresia, perforation [10], and intussusception [15].…”

Section: Discussionmentioning

confidence: 99%

Arteriovenous malformation that caused prolapse of the colon and was treated surgically in an infant: a case report

Kido¹,

Nakamura²,

Kuwahara³

et al. 2020

surg case rep

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Background: Various terms have been used to describe vascular lesions in the intestine, including angiodysplasia, arteriovenous malformation, and telangiectasia. Such lesions are common in adults and are typified by angiodysplasia, a type of arteriovenous malformation. In contrast, these lesions are rarely seen in the pediatric population. Angiodysplasia may cause gastrointestinal bleeding, which is sometimes an indication for treatment. Considering the high rate of recurrence after surgical treatment, conservative treatments are mainly chosen. We herein report an extremely rare case of a prolapsed colon due to an arteriovenous malformation successfully treated by resection in a 1-year-old girl. We also highlight the differences between pediatric and adult cases. Case presentation: A girl developed bloody stools at 7 months of age. She visited another hospital at 1 year of age because of continuing moderate hematochezia and recent onset of rectal prolapse. Colonoscopy showed a protruding lesion located 15 cm from the anal verge, suggesting a submucosal vascular abnormality. Contrastenhanced computed tomography and magnetic resonance imaging at our hospital revealed the localized lesion with dilated blood vessels in part of the sigmoid colon; no other lesions were present in the gastrointestinal tract. Laparoscopic-assisted sigmoidectomy was performed. A subserosal vascular lesion was visualized and resected using end-to-end anastomosis. Pathologic examination of the 2.2 × 2.7-cm segment revealed several abnormally enlarged and ectatic blood vessels in the submucosa extending into the subserosa. The lesion was diagnosed as an arteriovenous malformation. The patient had a good clinical course without recurrence at the 2-year follow-up. Conclusions: An arteriovenous malformation in the sigmoid colon may rarely cause intussusception and prolapse of the colon. Complete resection is a radical and potentially effective treatment. Computed tomography and colonoscopy were useful for evaluation of the lesion in the present case.

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Section: Discussionmentioning

confidence: 99%

Arteriovenous malformation that caused prolapse of the colon and was treated surgically in an infant: a case report

Kido¹,

Nakamura²,

Kuwahara³

et al. 2020

surg case rep

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“…However, the false negative rate of CE is approximately 19%, especially for the diagnosis of vascular malformation, Meckel's diverticulum, and small intestinal malignant tumor [ 25 ]. However, systematic studies focusing on the clinical value of CE in pediatric OGIB patients are limited [ 2 , 5 , 13 , 26 – 29 ] and there are no related studies of MGCE. Therefore, the etiology of gastrointestinal bleeding in minors and the sensitivity, specificity, and predicting factors of MGCE require a study.…”

Section: Discussionmentioning

confidence: 99%

Magnetic-Guided Capsule Endoscopy in the Diagnosis of Gastrointestinal Diseases in Minors

Qian

Bai

et al. 2018

Gastroenterology Research and Practice

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Objective This study aimed at investigating the clinical value of magnetic-guided capsule endoscopy (MGCE) in the diagnosis of gastrointestinal diseases in minors. Methods Eighty-four minor patients hospitalized in the pediatric department at Ruijin Hospital between June 2015 and January 2018 were enrolled for this study. Following bowel preparation, all patients underwent MGCE. The feasibility, safety, diagnostic yield, and sensitivity of MGCE were analyzed. Patients were followed up for more than 2 weeks. Results The main indications for MGCE in minors were Crohn's disease, gastrointestinal bleeding, and abdominal pain. The main causes of gastric disease were gastric inflammatory hyperplasia, exudative gastritis, and polyps. The most common small bowel diseases in minors were Crohn's disease, Henoch-Schonlein purpura, and polyps. The diagnostic yield in the stomach and small intestine was 13.1% and 28.6%, respectively, and the sensitivity was 100% and 96.0%, respectively. No adverse events occurred. Conclusion MGCE is a safe, effective, and well-tolerated procedure with good sensitivity and has a potential clinic value for the diagnosis of gastrointestinal diseases in minors.

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“…The overall diagnostic yield of BAE was about 70% [ 8 , 9 ]. The approach of CE followed by BAE might show a diagnostic yield over 90% [ 10 ]. However, this technology has not been widely used in children’s hospitals for concerns regarding safety, design of instruments, training, availability, and a lack of knowledge about its use and relative indications.…”

Section: Discussionmentioning

confidence: 99%

Exploratory laparoscopy combined with pathological examination in the diagnosis of obscure gastrointestinal bleeding in a child: a case report

et al. 2018

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BackgroundThe diagnosis of obscure gastrointestinal bleeding (OGIB) which is defined as bleeding of unknown origin of the small bowel by routine evaluation in childhood is a challenge.Case presentationHere we report a one-year-old Chinese girl who was suspected with idiopathic pulmonary haemosiderosis (IPH) and referred to our department for further diagnosis. Finally she was diagnosed with vascular malformations (VM) by exploratory laparoscopy combined with pathological examination.ConclusionsChildren OGIB could be easily misdiagnosed in the beginning, and OGIB children with active ongoing bleeding may benefit from proceeding directly to exploratory laparoscopy, followed by pathological confirmation of the diagnosis.

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Capsule endoscopy followed by single balloon enteroscopy in children with obscure gastrointestinal bleeding: A combined approach

Cited by 35 publications

References 30 publications

Arteriovenous malformation that caused prolapse of the colon and was treated surgically in an infant: a case report

Arteriovenous malformation that caused prolapse of the colon and was treated surgically in an infant: a case report

Magnetic-Guided Capsule Endoscopy in the Diagnosis of Gastrointestinal Diseases in Minors

Exploratory laparoscopy combined with pathological examination in the diagnosis of obscure gastrointestinal bleeding in a child: a case report

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