Capsule Endoscopy in the Evaluation of Patients With Unexplained Growth Failure

Abstract

In our study, 4 of the 7 older children and adolescents with unexplained growth failure and normal small bowel series were found to have Crohn disease involving the small intestine. In addition, we were able to show the improvement on the mean z score for weight after treatment of small bowel Crohn disease was instituted.

Wireless Capsule Endoscopy in Pediatric Gastrointestinal Diseases

“…On the other hand, a previous study showed the indication rate of suspected CD as 7.8% in adult patients (Rondonotti, 2010). Because a known CD increases a risk of capsule retention possibly caused by an intestinal stricture (Cheifetz, 2006;Moy, 2009;Atay, 2009), it is recommended to avoid the use of CE for the evaluation of known CD in both adult and children. In regard to the diagnostic accuracy, the previous pediatric study elucidated that CE was a more effective diagnostic tool in established CD patients compared with small-bowel radiography, CTE, and push enteroscopy (Thomson, 2007).…”

“…On the other hand, evaluation of entire small intestine is sometimes not completed because of prolonged gastric emptying and limited battery life (< 8h). In pediatric patients, completion rate of CE in the entire small intestine varies from 69 -89 % (Tokuhara, 2010;Guilhon de Araujo Sant'Anna, 2005;Atay, 2009;de'Angelis, 2007;Moy, 2009;Postgate, 2009). In order to improve the completion rate, mosapride citrate or laxatives are one of candidate to increase the ability to observe the entire small intestine, but there is no systematic study in regard to the use of mosapride or laxatives as a preparation drug for CE study in pediatric patients.…”

“…Transit time of CE and analyzed pathway by the software will help to assess the localization of detected abnormality in the small intestine. In pediatric patients with suspected small intestinal disease, CE detect abnormal findings in 55% (286/523) of cases (Tokuhara, 2010;de'Angelis, 2007;Atay, 2009;Fritscher-Ravens, 2009;Moy, 2009;Guilhon de Araujo Sant'Anna, 2005;Thomson, 2010;Argüelles-Arias, 2004;Pinho, 2008;Stiffler, 2003). Based on the detected abnormalities by CE in addition to the clinical and/or other laboratory informations, various small intestinal diseases are diagnosed or suggested, or further elucidated of their involvements of small intestinal lesions in known diseases (Table 1).…”

“…Indications were summarized based on the previous CE studies for pediatric patients, which included at least 10 CE examinations for suspected small intestinal diseases (Tokuhara, 2010;de'Angelis, 2007;Atay, 2009;Fritscher-Ravens, 2009;Moy, 2009;Guilhon de Araujo Sant'Anna, 2005;Thomson, 2010;. We excluded the studies with limited indications (ex.…”

Diagnostic Approach to Small Bowel Involvement in Inflammatory Bowel Disease: View of the Endoscopist

“…In the pediatric IBD patient group, WCE may be valuable in evaluating children with growth retardation when traditional studies have been unrevealing and in children with UC and IBDU may be used to reclassify the disease [38,39] . In a recent study, 4 of the 7 (57%) older children and adolescents with unexplained growth failure and normal SB series were found to have CD involving the small intestine [38] .…”