Successful Wireless Capsule Endoscopy for a 2.5-Year-Old Child: Obscure Gastrointestinal Bleeding From Mixed, Juvenile, Capillary Hemangioma-Angiomatosis of the Jejunum

Abstract

The lesion responsible for obscure gastrointestinal bleeding in the pediatric population may not be determined with standard primary endoscopic methods. Wireless capsule endoscopy, now a first-line modality for evaluation of the small bowel in the adult population, is a tool that may be useful among children. We report a case of a 2.5-year-old girl who presented with melenic stools. Upper and lower endoscopy, Meckel scans, and mesenteric angiography yielded negative results. Wireless capsule endoscopy identified numerous abnormal, dilated, blood vessels in the proximal jejunum, with associated fresh blood. The patient underwent surgical exploration, with resection of the affected portion of the jejunum. Pathologically, the dilated blood vessels were consistent with mixed, juvenile, capillary hemangioma-angiomatosis of developmental or congenital origin. The patient fared well postoperatively, with no additional bleeding in 9 months of follow-up monitoring. This case report highlights the use of capsule endoscopy in the diagnosis and successful treatment of gastrointestinal bleeding in a young infant. This is the youngest reported patient treated with the use of wireless capsule endoscopy in the pediatric population.

Equipment for pediatric endoscopy

“…[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Capsule endoscopy is approved by the U.S. Food and Drug Administration in children 2 years of age and older. Video capsules measure 11 ϫ 26 mm.…”

In-body Path Loss Model for Homogeneous Human Tissues

“…Capsule endoscopy has been accepted in adults by many gastroenterologists, however its usage in children has lagged due to the belief by pediatricians that the pills are too large to be swallowed by children [14], [15]. However, reports do suggest that children as young as two and a half years old are successfully undergoing capsule endoscopy [16]. The insulated dipole antennas are placed such that the Tx lies in the stomach and the Rx moves from 0.6 cm to 4 cm through the stomach (ǫ r = 62.16 and σ = 2.21 S/m) , and then moves partially into the liver (ǫ r = 54.81 and σ = 2.25 S/m) starting from 5 cm and and then entirely up to 12 cm.…”

Wireless capsule endoscopy: from diagnostic devices to multipurpose robotic systems

“…It detected the presence of OGIB even in 2.5 years old child, so far the youngest patient who has received WCE treatment (Kavin et al, 2006).…”