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P118. The diagnostic value of wireless capsule endoscopy in paediatric inflammatory bowel disease assessment: a tertiary centre experience

E. Saliakellis, L. Fotis, S. Sider, N. Shah, M. Elawad, K. Lindley, F. Kiparissi, Great Ormond Street Hospital, Paediatric Gastroenterology, London, United Kingdom

Background

Wireless capsule endoscopy (WCE) provides a method to assess small bowel pathology by filling the endoscopic gap between push-enteroscopy and ileocolonoscopy. The aim of this study was to assess the diagnostic value, tolerance and safety of WCE in paediatric patients with inflammatory bowel disease (IBD) referred to our unit.

Methods

This is a retrospective review of the WCE studies (PillCam SB, Given Imaging) that were performed from May 2007 to November 2012. Indications for the procedure were confirmed or suspected IBD [n = 146, Crohn's disease (CD) 58.9%, ulcerative colitis (UC) 6.2%, indeterminate colitis (IC) 22.6%, suspected IBD 12.3%].

Results

146 children (52.7% male, median age 13.2 years (range: 3.0 to 19.0 years) were included. 43.2% swallowed the capsule; in the remaining it was placed endoscopically into the duodenum under general anaesthesia using an acorn-like device “Roth net”. 18 patients (12.3%) were under the age of 8 years. In 73% of the cases the WCE was seen in the coecum at end of recording (8 hours) with a median small bowel transit time 236.5 minutes (range 71 to 494 minutes). 2 patients retained the capsule, only one needing surgical removal of terminal ileum stricture with a normal contrast study pre WCE. Positive findings were observed in 71.9% of which 60% were helpful in terms of either establishing a new diagnosis (12.3% of the cases) or altering the therapeutic approach of the patient (40.8% of the cases). The contribution of WCE among the above patient groups was significantly different for treatment modification (p = 0.003) but not for establishing a new or altering an existing diagnosis.

Conclusion

Our experience demonstrates that WCE is a useful and safe diagnostic modality in children with inflammatory bowel disease.