Ma Ming, Zhang Bing-ling, Chen Chun-xiao, Li Fu-bang, Huang Xiao-lei, Wang Pei-xin, Chen Jie
Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhonghua Er Ke Za Zhi. 2009 Oct;47(10):745-9.
The pathological change of small bowel is difficult to examine because it is anatomically unique. The development of wireless capsule endoscopy provides an unique opportunity to visualize the entire small bowel in a minimally invasive manner. The aim of this study was to assess the safety and clinical value of wireless capsule endoscopy in children.
During the last 4 years (June, 2004-June, 2008), 46 times of wireless capsule endoscopy were performed in 43 patients with suspected small bowel disease, including obscure gastrointestinal bleeding (n = 11), recurrent abdominal pain (n = 20), chronic diarrhea (n = 9), protein losing enteropathy (n = 2), recurrent vomiting (n = 1). Of the 43 cases, 28 were male and 15 were female, the age ranged from 6 to 18 years, 8 of these cases were < 10 years old. The weight of the patients ranged between 15 kg and 60 kg. The average time of capsule passing through the stomach and the small intestine, the tolerance to and complication of wireless capsule endoscopy in patients, the image quality of capsule endoscopy, and the cleanliness of small intestine after fasting for 8 hours were observed and recorded.
All the patients could easily swallow the capsule and had good tolerance. The overall success rate was 94% (43/46). The median time of capsule passing through the stomach and small intestine was 73 min (range, 3 - 600 min) and 246 min (range, 73 - 413 min), respectively. The diagnostic yield of pathological change in small intestine was 90% (37/41), and the diagnostic accordance rate was 84% (31/37). Based on the wireless capsule endoscopy, diagnostic findings included Crohn's diseases (15), lymph follicular hyperplasia (4), nonspecific enteritis (4), vascular malformations (3), small bowel tumour (2), primary intestinal lymphangiectasia (2), gastrointestinal motility disorders (2), Meckel's diverticulum (1), angioma (1), small intestinal worm disease (1), duodenal ulcer (1), and polyposis syndromes (1). The capsule of 1 patient remained in the stomach. The cleanliness of small intestine after 8 hours fasting was good. And the capsule endoscopy can show high quality small intestine image.
Wireless capsule endoscopy is a noninvasive, safe and useful tool for the investigation of the small intestine in children, especially for obscure gastrointestinal bleeding and Crohn's disease.
小肠的病理改变因其解剖结构独特而难以检查。无线胶囊内镜的发展为以微创方式观察整个小肠提供了独特的机会。本研究的目的是评估无线胶囊内镜在儿童中的安全性和临床价值。
在过去4年（2004年6月至2008年6月）期间，对43例疑似小肠疾病的患者进行了46次无线胶囊内镜检查，包括不明原因的消化道出血（n = 11）、反复腹痛（n = 20）、慢性腹泻（n = 9）、蛋白丢失性肠病（n = 2）、反复呕吐（n = 1）。43例患者中，男性28例，女性15例，年龄6至18岁，其中8例年龄小于10岁。患者体重在15千克至60千克之间。观察并记录胶囊通过胃和小肠的平均时间、患者对无线胶囊内镜的耐受性和并发症、胶囊内镜的图像质量以及禁食8小时后小肠的清洁度。
所有患者均能轻松吞下胶囊，耐受性良好。总体成功率为94%（43/46）。胶囊通过胃和小肠的中位时间分别为73分钟（范围3至600分钟）和246分钟（范围73至413分钟）。小肠病理改变的诊断率为90%（37/41），诊断符合率为84%（31/37）。基于无线胶囊内镜的诊断结果包括克罗恩病（15例）、淋巴滤泡增生（4例）、非特异性肠炎（4例）、血管畸形（3例）、小肠肿瘤（2例）、原发性肠淋巴管扩张症（2例）、胃肠动力障碍（2例）、梅克尔憩室（1例）、血管瘤（1例）、小肠蠕虫病（1例）、十二指肠溃疡（1例）和息肉病综合征（1例）。1例患者的胶囊滞留在胃内。禁食8小时后小肠清洁度良好。且胶囊内镜可显示高质量的小肠图像。
无线胶囊内镜是一种用于儿童小肠检查的无创、安全且有用的工具，尤其适用于不明原因的消化道出血和克罗恩病。
