Wu Jie, Huang Zhiheng, Wang Yuhuan, Tang Zifei, Lai Lingyu, Xue Aijuan, Huang Ying
Gastroenterology Department/Endoscopy Center.
Department of General Internal Medicine, Children's Hospital of Fudan University, Shanghai, China.
Medicine (Baltimore). 2020 Oct 23;99(43):e22864. doi: 10.1097/MD.0000000000022864.
Video capsule endoscopy (VCE) can detect mucosal lesions in the intestine, especially in the small bowel.Our study aims to evaluate the applications of VCE for pediatric gastrointestinal diseases.In this retrospective study, we included all patients who underwent VCE between December 2012 and December 2018. Clinical information and VCE data were analyzed.Among 828 patients, the completion rate was 99.6% (n = 825), with an average age of 10.2 ± 3.3 years old. A total of 459 VCE procedures showed abnormalities, and the overall diagnostic yield was 55.6%. The most common indications for VCE were abdominal pain among 505 (61.2%) patients and hematochezia (10.1%) among 83. Among the positive results of VCE, small bowel ulcers accounted for the highest percentage (57.7%), of which 164 cases were diagnosed as inflammatory bowel disease. For obscure gastrointestinal bleeding, 12 cases were diagnosed as Meckel's diverticulum. In terms of the small bowel transit time of VCE, compared with the negative group [288 (216.5, 390.3) min] and the enteritis group [277 (192.5, 374.8) min], a longer transit time was needed in the small bowel ulcer group [332.5 (240, 451.5) min, P < .01]. There were no correlations of positive VCE findings with anemia, the white blood cell count, the C-reactive protein level or the small bowel transit time according to Spearman rank analysis.VCE is relatively well tolerated and safe in children and has great value for the diagnosis and treatment of abdominal pain, especially inflammatory bowel disease and obscure gastrointestinal bleeding.
视频胶囊内镜检查(VCE)可检测肠道黏膜病变,尤其是小肠病变。我们的研究旨在评估VCE在儿科胃肠疾病中的应用。在这项回顾性研究中,我们纳入了2012年12月至2018年12月期间接受VCE检查的所有患者。对临床信息和VCE数据进行了分析。828例患者中,完成率为99.6%(n = 825),平均年龄为10.2±3.3岁。共459例VCE检查显示异常,总体诊断率为55.6%。VCE最常见的适应证是505例(61.2%)患者的腹痛和83例(10.1%)患者的便血。在VCE阳性结果中,小肠溃疡占比最高(57.7%),其中164例被诊断为炎症性肠病。对于不明原因的消化道出血,12例被诊断为梅克尔憩室。在VCE的小肠通过时间方面,与阴性组[288(216.5,390.3)分钟]和肠炎组[277(192.5,374.8)分钟]相比,小肠溃疡组需要更长的通过时间[332.5(240,451.5)分钟,P <.01]。根据Spearman秩分析,VCE阳性结果与贫血、白细胞计数、C反应蛋白水平或小肠通过时间均无相关性。VCE在儿童中耐受性相对良好且安全,对腹痛尤其是炎症性肠病和不明原因的消化道出血的诊断和治疗具有重要价值。