Applications of capsule endoscopy in pediatric patients

Introduction: The small bowel is part of the gastrointestinal tract that is difficult to visualize. The capsule endoscopy is the first painless procedure that is able to study the whole length of the small bowel. The main indication for capsule endoscopy in adults is to find the reason of obscure gastrointestinal bleeding. Another indication is to detect the manifestation of Crohn's disease in the small bowel. This examination is important in suspected Crohn's disease patient, especially if the conventional endoscopic and radiological examination methods could not give a full diagnosis. Capsule endoscopy cannot only help to prove the diagnostics but it can also demonstrate to what extent the disease has spread. At present there is little experience concerning the examination of children with the capsule endoscopy.

Methods: The authors describe the method of capsule endoscopy, the initial experiences and the examination of three children.

Results: One patient with suspected Crohn's disease had widespread small bowel lesions consistent with the diagnosis. Two patients were examined with obscure gastrointestinal bleeding. The capsule endoscopy could find a bleeding source in one of the patients studied by capsule during overt bleeding. In the other case it was not possible to find the location of the bleeding.

Conclusions: The capsule endoscopy is a new diagnostic possibility, which is at present the most sensitive diagnostic method in cases with symptoms suggesting small bowel disease. This new method is optimally complementing the conventional endoscopic and radiological activity.