Children's Medical Center Dallas, University of Texas Southwestern, Dallas, Texas 75235, USA.
Curr Opin Pediatr. 2011 Oct;23(5):530-4. doi: 10.1097/MOP.0b013e32834a1b61.
Endoscopic investigation of small bowel disorders in children has historically been difficult due to the length and tortuosity of the organ itself. New technology introduced over the past decade allows minimally invasive, detailed endoscopic evaluation of the small bowel mucosa from the duodenum to the cecum. While understudied in the pediatric population, literature is emerging supporting the use of these techniques and devices in children.
Well tolerated and clinically useful capsule endoscopy has been reported a number of times in children, and the indications and potential complications of this procedure are discussed. The limitations of capsule endoscopy, namely inability to biopsy and treat small bowel lesions, have been addressed to some extent by the introduction of balloon enteroscopy, which allows deep intubation of the small bowel, and at times viewing of the entire mucosal surface. Balloon enteroscopy has been safely reported in children as small as 13.1 kg, and has been successfully performed in children with Roux-en-Y anastomoses in the evaluation and therapy of biliary strictures.
New enteroscopic techniques now allow detailed investigation and therapy of small bowel lesions in a minimally invasive fashion in the pediatric population.
由于小肠本身的长度和迂曲,儿童小肠疾病的内镜检查在历史上一直具有挑战性。过去十年中引入的新技术允许对从十二指肠到盲肠的小肠黏膜进行微创、详细的内镜评估。尽管在儿科人群中的研究较少,但越来越多的文献支持在儿童中使用这些技术和设备。
多次报道了胶囊内镜在儿童中得到了很好的耐受和临床应用,并且讨论了该操作的适应证和潜在并发症。胶囊内镜的局限性,即无法活检和治疗小肠病变,在一定程度上通过引入球囊小肠镜得到解决,该技术允许小肠深部插管,有时可观察整个黏膜表面。球囊小肠镜在体重低至 13.1 千克的儿童中被安全报道,并且在评估和治疗胆管狭窄的 Roux-en-Y 吻合术后的儿童中成功实施。
新的小肠内镜技术现在允许在儿科人群中以微创的方式对小肠病变进行详细的检查和治疗。