Article Text

other Versions

The feasibility of wireless capsule endoscopy in detecting small intestinal pathology in children under the age of 8 years – a.Multicentre European Study
  1. Annette Fritscher-Ravens (fri.rav{at}
  1. Homerton University Hospital, United Kingdom
    1. Peter Scherbakov (petersh{at}
    1. Academy of Medical Sciences, Moscow, Russian Federation
      1. Philip Bufler (philip.bufler{at}
      1. Childrens Hospital Munich, Germany
        1. Filipo Torroni (ftorroni{at}
        1. Bambino Gesu Hospital, Italy
          1. Tarja Ruuska (tarja.ruuska{at}
          1. University Hospital, Tampere, Finland
            1. Hannu Nuutinen (hannu.nuutinen{at}
            1. Childrens Hospital, Helsinki, Finland
              1. Michael Thomson (mike.thomson{at}
              1. Childrens Hospital, Sheffield, United Kingdom
                1. Merit Tabbers (m.m.tabbers{at}
                1. Emma Childrens Hospital, Amsterdam, Netherlands
                  1. Peter Milla (p.milla{at}
                  1. UCL Institute of Child Health, London, United Kingdom


                    Objective: To systematically evaluate the feasibility and methodology to carry out wireless capsule endoscopy (WCE) in children<8 years to define small intestinal pathology.

                    Design: Prospective European Multicenter study with negative prior investigation.

                    Patients and interventions: 83 children age 1.5-7.9 years were recruited. Initially, all were offered “swallowing” (Group1) for capsule introduction. If this failed endoscopic placement (Group2) was used and Roth net, Advance™ or custom-made introducers were compared.

                    Outcome measures: Primary endpoint: to determine pathology, secondary endpoint: comparison of capsule introduction methods.

                    Results: Capsule introduction: 20 (24%) children age 4.0-7.9 years (mean: 6.9 yrs) (14 male) comprising Group 1 were older (p<0.025) than 63 (76%) age 1.5– 7.9 years (mean 5.25 yrs, 30 male) forming Gp2. Complications: Roth Net mucosal trauma in 50%; no others occurred. The available recording apparatus was inappropriate for those <3years.

                    Indications: GI bleeding: n=30 (16 positive findings:4 ulcerative jejunitis,4 polyps,2 angiodysplasia,2 blue rubber blebs, 2 Meckels diverticula,1 anastomotic ulcer,1 reduplication); suspected Crohn's disease(CD): n=20 (11 had CD); abdominal pain: n=12 (6 positive findings:3 CD, 2 lymphonodular hyperplasia, 1 blue rubber bleb); protein loss: n=9 (4 lymphangectasia); malabsorption: n=12 (7 positive findings:6 enteropathy,1 ascaris). No abnormalities overall: 45%.

                    Conclusion: WCE is feasible and safe down to the age of 1.5 years. 20 children >4 years swallowed the capsule. The Advance™ introducer proved superior for endoscopic placement. The pathologies encountered showed age specificity and unlike adolescents obscure GI bleeding was the commonest indication.

                    Statistics from

                    Request permissions

                    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

                    Linked Articles

                    • Digest
                      Robin Spiller Severine Vermeire