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Vol. 89. Núm. 2.
Páginas 204-209 (Março - Abril 2013)
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Vol. 89. Núm. 2.
Páginas 204-209 (Março - Abril 2013)
Artigo Original
Open Access
Role of wireless capsule endoscopy in reclassifying inflammatory bowel disease in children
Visitas
2221
Jodie Ouaheda, Mohammad Shagranib, Ana Sant’Annac,
Autor para correspondência
ana.santanna@mcgill.ca

Corresponding author.
a Médico, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontário, Canadá
b Médico, Division of Pediatric Gastroenterology, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Hamilton, Ontário, Canadá
c Médico, Department of Pediatrics, Division of Gastroenterology, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canadá
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Abstract
Objective

To evaluate the role of wireless capsule endoscopy in identifying small bowel lesions in pediatric patients with newly diagnosed colonic inflammatory bowel disease (IBD) type unclassified (IBDU), and to assess whether capsule endoscopy findings result in altered patient management.

Methods

Ten pediatric patients recently diagnosed with IBDU through standard investigations were recruited from the pediatric gastroenterology clinic at McMaster Children's Hospital to undergo capsule endoscopy using the Pillcam SBTM (Given Imaging) capsule. Findings consistent with a diagnosis of Crohn's disease required the identification of at least three ulcerations.

Results

Three out of ten patients had newly identified findings on capsule endoscopy that met criteria for Crohn's disease. Three more patients had findings suspicious for Crohn's disease, but failed to meet the diagnostic criteria. Three additional patients had findings most consistent with ulcerative colitis, and one had possible gastritis with a normal intestine. Findings from capsule endoscopy allowed for changes in the medical management of three patients. In all ten cases, capsule endoscopy allowed for a better characterization of the type and extent of disease. No adverse outcomes occurred in the present cohort.

Conclusion

This prospective study reveals that wireless capsule endoscopy is feasible, valuable, and non-invasive, offering the ability to potentially better characterize newly

Palavras chave:
Cápsula endoscópica
Doença inflamatória intestinal inespecífica
Pediátrico
Keywords:
Wireless capsule endoscopy
Indeterminate inflammatory bowel disease
Paediatrics
Resumo
Objetivo

Avaliar o papel da cápsula endoscópica na identificação de lesões no intestino delgado em pacientes pediátricos com DII inespecífica (DIII) diagnosticada recentemente e avaliar se os achados da cápsula endoscópica resultam em alterações no tratamento dos pacientes.

Métodos

Dez pacientes pediátricos recém-diagnosticados com DIII por meio de investigações padrão foram recrutados da clínica de gastroenterologia pediátrica no McMaster Children's Hospital, para serem submetidos a exame com a cápsula endoscópica Pillcam SB™ (Given Imaging). Achados compatíveis com o diagnóstico da doença de Crohn exigiram a identificação de pelo menos três ulcerações.

Resultados

De 10 pacientes, três apresentaram achados novos com a cápsula endoscópica que satisfizeram o critério para a doença de Crohn. Outros três apresentaram achados com suspeita de doença de Crohn, porém não atenderam nossos critérios de diagnóstico. Apresentaram achados mais compatíveis com colite ulcerativa outros três pacientes, e um apresentava possível gastrite com intestino normal. Os achados da cápsula endoscópica possibilitaram mudanças no tratamento médico de três pacientes. Em todos os dez casos, a cápsula endoscópica permitiu uma melhor caracterização do tipo e da extensão da doença. Não houve resultado adverso em nossa coorte.

Conclusão

Este estudo prospectivo revela que a cápsula endoscópica é viável, útil e não invasiva, que oferece a possibilidade de melhor caracterização de casos de DIII pediátricos recém-diagnosticados ao identificar lesões no intestino delgado e reclassificá-las como doença de Crohn.

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Como citar este artigo: Ouahed J, Shagrani M, Sant’Anna A. Role of wireless capsule endoscopy in reclassifying inflammatory bowel disease in children. J Pediatr (Rio J). 2013;89:204−9.

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