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

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Abstract

Purpose

The aim of our study was to determine the safety and usefulness of capsule endoscopy (CE) in pediatric patients.

Methods

We prospectively examined children (aged 10–18 years) with suspected small bowel disease and recorded capsule transit times, findings, and complications.

Results

We performed 19 CE examinations in 12 patients (median age 11.8 years; range 10–18 years). One of the two patients with obscure gastrointestinal bleeding (OGIB), a 14-year-old girl whose OGIB occurred after cord-blood transplantation due to leukemia, was diagnosed with thrombotic microangiopathy. Repeated CE allowed visualization of real-time mucosal changes, such as the improvement of ulcers and bleeding, and newly emerged lymphangiectasia, without causing the patient physical and mental stress. This information facilitated both subsequent evaluation of the clinical course and determination of the appropriate treatment strategy. In the second patient with chronic OGIB, a 10-year-old girl, the detection of severe ileal stenoses by capsule retention led to the diagnosis of non-specific multiple ulcers of the small intestine. After ileal resection, repeated CE detected the recurrence of multiple ulcers and enabled the optimal treatment strategy to be applied. CE confirmed small bowel involvement in a patient with unresponsive Crohn’s disease (CD) and excluded CD in all five patients with suspected CD. Similarly, CE confirmed the absence of small bowel involvement in three of the four patients with recurrent abdominal pain, although one patient had nodular lymphoid hyperplasia.

Conclusions

Based on our results, CE is a valuable tool in the differential diagnoses of small bowel diseases, and repeated examination can provide real-time information that will enable evaluation of the clinical course in pediatric patients.

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Authors and Affiliations

  1. Department of Pediatrics, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka, 545-8585, Japan

    Daisuke Tokuhara, Yoshiyuki Okano, Akio Tada, Kazumi Yamato, Takahiro Mochizuki & Tsunekazu Yamano

  2. Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka, 545-8585, Japan

    Kenji Watanabe & Tetsuo Arakawa

  3. Department of Pediatrics, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8506, Japan

    Junji Takaya

Authors
  1. Daisuke Tokuhara
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  2. Kenji Watanabe
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  3. Yoshiyuki Okano
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  4. Akio Tada
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  5. Kazumi Yamato
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  6. Takahiro Mochizuki
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  7. Junji Takaya
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  8. Tsunekazu Yamano
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  9. Tetsuo Arakawa
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Correspondence to Daisuke Tokuhara.

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Tokuhara, D., Watanabe, K., Okano, Y. et al. Wireless capsule endoscopy in pediatric patients: the first series from Japan. J Gastroenterol 45, 683–691 (2010). https://doi.org/10.1007/s00535-010-0209-5

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  • DOI: https://doi.org/10.1007/s00535-010-0209-5

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