Compartilhar
Informação da revista
Vol. 89. Núm. 2.
Páginas 204-209 (Março - Abril 2013)
Compartilhar
Compartilhar
Baixar PDF
Mais opções do artigo
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
...
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
Informação do artigo
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.

O texto completo está disponível em PDF
Referências
[1]
V. Maunoury, G. Savoye, A. Bourreille, Y. Bouhnik, M. Jarry, S. Sacher- Huvelin, et al.
Value of wireless capsule endoscopy in patients with indeterminate colitis (inflammatory bowel disease type unclassified).
Inflamm Bowel Dis., 13 (2007), pp. 152-155
[2]
J. Stewénius, I. Adnerhill, G. Ekelund, C.H. Florén, F.T. Fork, L. Janzon, et al.
Ulcerative colitis and indeterminate colitis in the city of Malmö, Sweden. A 25-year incidence study.
Scand J Gastroenterol., 30 (1995), pp. 38-43
[3]
M.S. Silverberg, J. Satsangi, T. Ahmad, I.D. Arnott, C.N. Bernstein, S.R. Brant, et al.
Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: Report of a Working Party of the 2005 Montreal World Congress of Gastroenterology.
Can J Gastroenterol., 19 (2005), pp. 5-36
[4]
K. Geboes, G. De Hertogh.
Indeterminate colitis.
Inflamm Bowel Dis., 9 (2003), pp. 324-331
[5]
K.A. Papadakis, S.K. Lo, Z. Fireman, S. Hollerbach.
Wireless capsule endoscopy in the evaluation of patients with suspected or known Crohn's disease.
Endoscopy., 37 (2005), pp. 1018-1022
[6]
R. Eliakim, S.N. Adler.
Capsule video endoscopy in Crohn's disease – the European experience.
Gastrointest Endosc Clin N Am., 14 (2004), pp. 129-137
[7]
S. Mehdizadeh, G.C. Chen, L. Barkodar, P.J. Enayati, S. Pirouz, M. Yadegari, et al.
Capsule endoscopy in patients with Crohn's disease: diagnostic yield and safety.
Gastrointest Endosc., 71 (2010), pp. 121-127
[8]
M. Thomson, A. Fritscher-Ravens, M. Mylonaki, P. Swain, M. Eltumi, R. Heuschkel, et al.
Wireless capsule endoscopy in children: a study to assess diagnostic yield in small bowel disease in paediatric patients.
J Pediatr Gastroenterol Nutr., 44 (2007), pp. 192-197
[9]
A.M. Guilhon de Araujo Sant’Anna, J. Dubois, M.C. Miron, E.G. Seidman.
Wireless capsule endoscopy for obscure small-bowel disorders: final results of the first pediatric controlled trial.
Clin Gastroenterol Hepatol., 3 (2005), pp. 264-270
[10]
E.G. Seidman, A.M. Sant’Anna, M.H. Dirks.
Potential applications of wireless capsule endoscopy in the pediatric age group.
Gastrointest Endosc Clin N Am., 14 (2004), pp. 207-217
[11]
R. Shamir, R. Eliakim.
Capsule endoscopy in pediatric patients.
World J Gastroenterol., 14 (2008), pp. 4152-4155
[12]
A. Fritscher-Ravens, P. Scherbakov, P. Bufler, F. Torroni, T. Ruuska, H. Nuutinen, et al.
The feasibility of wireless capsule endoscopy in detecting small intestinal pathology in children under the age of 8 years: a multicentre European study.
Gut., 58 (2009), pp. 1467-1472
[13]
Z.Z. Ge, H.Y. Chen, Y.J. Gao, J.L. Gu, Y.B. Hu, S.D. Xiao.
Clinical application of wireless capsule endoscopy in pediatric patients for suspected small bowel diseases.
Eur J Pediatr., 166 (2007), pp. 825-829
[14]
W. El-Matary.
Wireless capsule endoscopy: indications, limitations, and future challenges.
J Pediatr Gastroenterol Nutr., 46 (2008), pp. 4-12
[15]
J.O. Clarke, S.A. Giday, P. Magno, E.J. Shin, J.M. Buscaglia, S.B. Jagannath, et al.
How good is capsule endoscopy for detection of periampullary lesions? Results of a tertiary-referral center.
Gastrointest Endosc., 68 (2008), pp. 267-272
[16]
O. Atay, L. Mahajan, M. Kay, F. Mohr, B. Kaplan, R. Wyllie.
Risk of capsule endoscope retention in pediatric patients: a large single-center experience and review of the literature.
J Pediatr Gastroenterol Nutr., 49 (2009), pp. 196-201
[17]
G.L. de’ Angelis, F. Fornaroli, N. de’ Angelis, B. Magiteri, B. Bizzarri.
Wireless capsule endoscopy for pediatric small-bowel diseases.
Am J Gastroenterol., 102 (2007), pp. 1749-1758
[18]
A. Swaminath, P. Legnani, A. Kornbluth.
Video capsule endoscopy in inflammatory bowel disease: past, present, and future redux.
Inflamm Bowel Dis., 16 (2010), pp. 1254-1262
[19]
R. Sidhu, D.S. Sanders, M.E. McAlindon, M. Thomson.
Capsule endoscopy and enteroscopy: modern modalities to investigate the small bowel in paediatrics.
Arch Dis Child., 93 (2008), pp. 154-159
[20]
R. Sidhu, M.E. McAlindon, D.S. Sanders, M. Thomson.
Capsule endoscopy in the evaluation of gastrointestinal disease.
Curr Opin Pediatr., 19 (2007), pp. 586-590
[21]
J.M. Herrerías, A. Caunedo, M. Rodríguez-Téllez, F. Pellicer, J.M. Herrerías Jr..
Capsule endoscopy in patients with suspected Crohn's disease and negative endoscopy.
Endoscopy., 35 (2003), pp. 564-568
[22]
M. Pennazio, endoscopy. Capsule.
Endoscopy, 37 (2005), pp. 1073-1078
[23]
F. Argüelles-Arias, A. Caunedo, J. Romero, A. Sánchez, M. Rodríguez- Téllez, F.J. Pellicer, et al.
The value of capsule endoscopy in pediatric patients with a suspicion of Crohn's disease.
Endoscopy., 36 (2004), pp. 869-873
[24]
A. Silbermintz, J. Levine.
Capsule endoscopy in the evaluation of patients with suspected Crohn's disease: expanding experience into the pediatric age group.
Isr Med Assoc J., 10 (2008), pp. 468-472
[25]
J.L. Goldstein, G.M. Eisen, B. Lewis, I.M. Gralnek, S. Zlotnick, J.G. Fort, et al.
Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo.
Clin Gastroenterol Hepatol., 3 (2005), pp. 133-141
[26]
C. Oloughlin, N. Slinde, S. Kugathasen.
The utility of wireless capsule endoscopy in the evaluation of suspected Crohns disease in the pediatric population.
GI Endoscopy., 63 (2006), pp. AB185
[27]
L. Moy, J. Levine.
Wireless capsule endoscopy in the pediatric age group: experience and complications.
J Pediatr Gastroenterol Nutr., 44 (2007), pp. 516-520
[28]
L. Moy, J. Levine.
Capsule endoscopy in the evaluation of patients with unexplained growth failure.
J Pediatr Gastroenterol Nutr., 48 (2009), pp. 647-650
[29]
S.A. Cohen, I.M. Gralnek, H. Ephrath, L. Saripkin, W. Meyers, O. Sherrod, et al.
Capsule endoscopy may reclassify pediatric inflammatory bowel disease: a historical analysis.
J Pediatr Gastroenterol Nutr., 47 (2008), pp. 31-36
[30]
I.M. Gralnek, S.A. Cohen, H. Ephrath, A. Napier, T. Gobin, O. Sherrod, et al.
Small bowel capsule endoscopy impacts diagnosis and management of pediatric inflammatory bowel disease: a prospective study.
Dig Dis Sci., 57 (2012), pp. 465-471

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.

Copyright © 2013. Sociedade Brasileira de Pediatria
Idiomas
Jornal de Pediatria

Receba a nossa Newsletter

Opções de artigo
Ferramentas
en pt
Taxa de publicaçao Publication fee
Os artigos submetidos a partir de 1º de setembro de 2018, que forem aceitos para publicação no Jornal de Pediatria, estarão sujeitos a uma taxa para que tenham sua publicação garantida. O artigo aceito somente será publicado após a comprovação do pagamento da taxa de publicação. Ao submeterem o manuscrito a este jornal, os autores concordam com esses termos. A submissão dos manuscritos continua gratuita. Para mais informações, contate assessoria@jped.com.br. Articles submitted as of September 1, 2018, which are accepted for publication in the Jornal de Pediatria, will be subject to a fee to have their publication guaranteed. The accepted article will only be published after proof of the publication fee payment. By submitting the manuscript to this journal, the authors agree to these terms. Manuscript submission remains free of charge. For more information, contact assessoria@jped.com.br.
Cookies policy Política de cookies
To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.