Comparing swallowed to endoscopic placement in children having capsule endoscopy

Abstract

Introduction: Capsule endoscopy (CE) is increasingly performed as it offers a method of directly visualising areas of the small bowel not seen with conventional endoscopy. Some children are unable to swallow the capsule so require endoscopic placement under general anaesthesia (GA). There is however limited information on demographics and outcomes in children requiring capsule placement. The aim of our study was therefore to examine whether there are any differences between children requiring endoscopic placement (GA) and those able to swallow the capsule. Methods: Retrospective chart review of consecutive capsule endoscopy in a tertiary paediatric centre. Patient demographics, outcomes, and complications between the two groups were noted. Paired t-test was used to compare continuous variables while Fisher exact test was used for categorical data using GraphPad software. Results: 99 capsules were performed in 85 patients, with median age 13.01 (range 1.61-17.36) years and weight 46 (range 10-97) kg. Almost half were able to swallow the capsule. 68% (34/50) of patients undergoing endoscopic placement had concurrent procedures performed at the same time, mainly upper endoscopy and colonoscopy. Patient demographics are shown in table below. CE was unsuccessful in 1 patient who swallowed the capsule as it failed to pass the stomach and delayed entry into the duodenum was reported in 6 cases. Poor views were found in 30% (15/50) of patients in the GA group due to bleeding from biopsies taken concurrently with capsule placement. No adverse outcomes or capsule retention occurred in this cohort. Conclusions: CE is safe and well tolerated in children. Children requiring placement of CE were significantly younger, lighter, had longer small intestine transit time, and were less likely to have positive findings. Concurrent biopsies with CE increase likelihood of inadequate views and are therefore not recommended. (Table Presented).L720627122015-11-05 <br />