Capsule endoscopy in pediatric patients: Technique and results in our first 100 consecutive children

Nuutinen, Hannu; Kolho, Kaija-Leena; Salminen, Päivi; Rintala, Risto; Koskenpato, Jari; Koivusalo, Antti; Sipponen, Taina; Färkkilä, Martti

doi:10.3109/00365521.2011.584900

Cited by 52 publications

(40 citation statements)

References 29 publications

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“…The youngest child in the study was 1.5 years old. A recent study by Jensen et al 26 of WCE in 117 children included a 10-month-old infant weighing 11.5 kg and Nuutinen et al 3 has also reported the feasibility of capsule endoscopy in children as young as 8 months of age. In our series, the youngest patient is a 1-year 7-month-old girl who weighed only 9 kg.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of small bowel capsule endoscopy in children under the age of 4 years: a single centre experience

Vadamalayan

Hii

Kark

et al. 2012

Frontline Gastroenterol

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Data on the use of wireless capsule endoscopy (WCE) in younger children remain limited. However, this single centre study suggests that it is a relatively complication-free procedure that may be considered in younger children below 4 years of age, when small bowel pathology is suspected. We retrospectively reviewed the King's College Hospital WCE database between August 2009 and August 2011. Patients aged 4 years or younger were included in the study. Six children fulfilled the inclusion criteria. The indications for WCE were unexplained gastrointestinal tract (GIT) bleeding (n=4), chronic diarrhoea with (n=1) and without (n=1) GIT bleeding (n=1). All had an oesophagogastroduodenoscopy and an ileocolonoscopy before WCE. The mean age at the time of WCE was 2 years 6 months (range 1 year 7 months to 3 years 7 months). The mean weight at WCE was 13.3 kg (range 9-17 kg). Four children had a complete study.

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Section: Discussionmentioning

confidence: 99%

Feasibility of small bowel capsule endoscopy in children under the age of 4 years: a single centre experience

Vadamalayan

Hii

Kark

et al. 2012

Frontline Gastroenterol

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“…Such studies typically include patients with known or suspected GI disease for indications such as obscure GI bleeding, undiagnosed abdominal pain, suspected Crohn's disease, ulcerative colitis, celiac disease, and small bowel tumors (Fireman et al, 2007). Based on 11 capsule endoscopy studies (Fireman et al, 2005(Fireman et al, , 2007Velayos Jiménez et al, 2005;Ge et al, 2007;Tokuhara et al, 2010;Nuutinen et al, 2011;Robinson et al, 2011;Westerhof et al, 2012;Yazici et al, 2012;OikawaKawamoto et al, 2013;Ou et al, 2014), which provided information on 16 unique subject groups with mean ages ranging from 2.9 to 64 years, a meta-regression was performed using a similar methodology as described previously. The analysis depicted a negative correlation between age and mean SITT using a linear model (Fig.…”

Section: Discussionmentioning

confidence: 99%

Examining Small Intestinal Transit Time as a Function of Age: Is There Evidence to Support Age-Dependent Differences among Children?

Maharaj

Edginton

2016

Drug Metabolism and Disposition

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The small intestine represents the region where the majority of drug and nutrient absorption transpires. Among adults, small intestinal transit kinetics is well delineated; however, the applicability of these values toward children remains unclear. This article serves to examine the relationship between age and mean small intestinal transit time (SITT) based on the available literature. In addition, the influence of alterations in intestinal transit time was explored among children using a model-based approach. Primary literature sources depicting SITT from children to adults were ascertained via the PubMed database. Data were limited to subjects without pathologies that could influence intestinal motility. Random-effect meta-regression models with between-study variability were employed to assess the influence of age on SITT. Three separate models with age as a linear or higher-order (i.e., second-and third-order polynomial) regressor were implemented to assess for the potential of both linear and curvilinear relationships. Examination of the influence of altered intestinal transit kinetics on the absorption of a sustained release theophylline preparation was explored among children between 8 and 14 years using physiologically based pharmacokinetic (PBPK) modeling. Age was not found to be a significant modulator of small intestinal transit within either the linear or higher-order polynomial meta-regression models. PBPK simulations indicated a lack of influence of variations in SITT on the absorption of theophylline from the examined sustained release formulation in older children. Based on the current literature, there is no evidence to suggest that mean SITT differs between children and adults.

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“…In 2009 the FDA approved VCE for children of 2 years or older. The youngest age of a child undergoing a VCE study was 8 mo[95], and the lowest weight was 7.9 kg[96]. Voluntary ingestion seems feasible at an age older than 6-8 years[94], and has already been reported in a child of 4 years[86].…”

Section: Vce In Childrenmentioning

confidence: 99%

Contraindications for video capsule endoscopy

Bandorski¹,

Kurniawan²,

Baltes³

et al. 2016

WJG

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Video capsule endoscopy (VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality. In patients with a higher incidence of stenosis, as in an established diagnosis of Crohn’s disease, clinical signs of obstruction, prior radiation or surgical small bowel resection, a preceding test with the self-dissolving patency capsule can override this contraindication. Endoscopic placement of the capsule should be considered in patients with swallowing disorders to avoid aspiration. Esophageal or gastric motility disorders may require endoscopic capsule transport or application of prokinetics if the real-time viewer proofs delayed transit. In pregnant women, VCE should be restricted to urgent cases where diagnosis cannot be postponed after delivery, as data on safety are missing. There is theoretical and clinical evidence that patients with implanted cardiac devices such as a pacemaker, cardioverters or left heart assist devices, can safely undergo VCE in spite of still existing contraindication by manufacturers. Children from the age of 2 years have safely undergone VCE. Although video capsules are not proven safe with magnetic resonance imaging (MRI), first single cases of patients incidentally undergoing MRI with an incorporated capsule have been reported, showing susceptibility artifacts but no signs of clinical harm.

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Capsule endoscopy in pediatric patients: Technique and results in our first 100 consecutive children

Abstract: This study shows that CE is a feasible diagnostic method to study the small intestine in pediatric patients and that CE can be done in children as young as 8 months old. The diagnostic yield is highest in cases with bleeding or a high suspicion of Crohn's disease.

Cited by 52 publications

References 29 publications

Feasibility of small bowel capsule endoscopy in children under the age of 4 years: a single centre experience

Feasibility of small bowel capsule endoscopy in children under the age of 4 years: a single centre experience

Examining Small Intestinal Transit Time as a Function of Age: Is There Evidence to Support Age-Dependent Differences among Children?

Contraindications for video capsule endoscopy

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