Burgess Christopher J, McIntyre Emma C, Withers Geoffrey D, Ee Looi C
Department of Gastroenterology, Hepatology and Liver Transplant Lady Cilento Children's Hospital Brisbane Queensland Australia.
Discipline of Paediatrics and Child Health University of Queensland Brisbane Queensland Australia.
JGH Open. 2017 Sep 18;1(1):11-14. doi: 10.1002/jgh3.12001. eCollection 2017 Sep.
Capsule endoscopy (CE) offers a method of directly visualizing areas of the small bowel not accessible by conventional endoscopy. Some children are unable to swallow the capsule requiring endoscopic placement under general anesthesia. The aim of the present study was to identify any differences between children requiring endoscopic placement and those able to swallow the capsule.
Retrospective chart review of consecutive CE in a tertiary pediatric center was conducted. Patient demographics, outcomes, and complications between the two groups were noted. Paired -test comparing continuous variables and Fisher exact test for categorical data were used.
A total of 104 CEs were performed in 88 patients, median age 12.8 (range: 1.6-18.5) years. Almost half, 49% (51/104), swallowed the capsule. Children requiring endoscopic placement were significantly younger (9.8 14.2 years; < 0.001), lighter (34.5 54.9 kg; < 0.0001), and had longer small intestinal transit time (308 229 min; < 0.0001). Positive findings were more likely in those who swallowed the capsule (50% 30%, = 0.017), likely a reflection of the indications for procedure. Poor views were found in 30% (16/53) of patients in the endoscopic placement group due to iatrogenic bleeding from biopsies taken from concurrent procedures but did not affect outcome or subsequent patient management.
CE is safe and well tolerated in children. Children requiring endoscopic placement were significantly younger, lighter, had longer small intestine transit time, and less likely to have positive findings. Concurrent biopsies during capsule placement increase the likelihood of inadequate views but did not affect outcome or management.
胶囊内镜检查（CE）提供了一种直接观察传统内镜无法到达的小肠区域的方法。一些儿童无法吞咽胶囊，需要在全身麻醉下进行内镜放置。本研究的目的是确定需要内镜放置的儿童与能够吞咽胶囊的儿童之间的任何差异。
对一家三级儿科中心连续进行的CE进行回顾性病历审查。记录两组患者的人口统计学资料、结果和并发症。使用配对t检验比较连续变量，使用Fisher精确检验分析分类数据。
88例患者共进行了104次CE检查，中位年龄12.8岁（范围：1.6 - 18.5岁）。几乎一半，即49%（51/104）的患者吞咽了胶囊。需要内镜放置的儿童明显更年幼（9.8±4.2岁；P<0.001）、体重更轻（34.5±14.9kg；P<0.0001），小肠传输时间更长（308±229分钟；P<0.0001）。吞咽胶囊的患者更有可能有阳性发现（50%对30%，P = 0.017），这可能反映了检查的适应证。内镜放置组30%（16/53）的患者视野不佳，原因是同期操作活检引起的医源性出血，但这并不影响检查结果或后续患者管理。
CE在儿童中是安全的，耐受性良好。需要内镜放置的儿童明显更年幼、体重更轻、小肠传输时间更长，且阳性发现的可能性更小。胶囊放置期间同期活检会增加视野不佳的可能性，但不影响检查结果或管理。
