Use of capsule endoscopy in children with primary intestinal lymphangiectasia

Wireless capsule endoscopy in pediatric patients: the first series from Japan

“…Studies of adult patients have revealed that CE is superior to the small bowel series for evaluating the small intestine [1][2][3]. A number of recent studies on pediatric patients have demonstrated that CE is also a useful in children with abdominal complaints, although the application of CE in this patient population has received relatively less attention compared to the adult patient population [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. The indications for CE in both children and adults include obscure gastrointestinal bleeding (OGIB), Crohn's disease (CD), and lymphangiectasia; in adults, suspected tumors of the small bowel also suggest the need for CE [9,[12][13][14].…”

MRI in Primary Intestinal Lymphangiectasia: A Diagnostic Tool and to Delineate Localization of Involvement

“…This approach has significant shortcomings as the lymphatics maybe dilated only post prandial and not visualized when the endoscopy and biopsy were performed [3]. In addition if the region of small bowel involvement is distal to the duodenum this approach would give a falsely normal result [4][5][6][7][8][9][10][11]. This aspect assumes more significance as it's the patients who have localized involvement, benefit most from a definitive surgery wherein the involved segment would be removed and the patient would lead a normal life, with normal no dietary restrictions thereafter [13][14][15].…”

“…The cost and availability of VCE continue to be a hindrance to its widespread usage as well. Imaging with MRI has been used as non-invasive diagnostic tools and also for excluding other factors that may cause secondary IL [5,[8][9][10]16,17]. The usage of MRI has an inherent advantage over CT and VCE but its findings and utility in children with IL have been rarely reported.…”

“…Given the rarity of PIL the evaluation and management strategies have not changed much over the past decade [2]. There have been reports on successful usage of computerized tomography (CT) scan and video capsule endoscopy (VCE) to diagnose and delineate the extent of intestinal involvement [4][5][6][7][8][9][10][11][12]. The significance of determining the extent of involvement lies in the good response to surgical excision of the involved intestinal segment if a localized disease is present, as medical management outcomes are modest and often frustrating [13][14][15].…”

Protein losing enteropathy in children

“…Endoscopic and biopsy findings may be normal in case of local and segmental involvement. In this case, the segment with lymphangiectasia may be found using video capsule endoscopy (25). Enlarged and marked intestinal and mesenteric lymphatics may be also evaluated using computerized tomography (CT) and magnetic resonance imaging (MR) (1,11).…”