Esophageal Capsule Endoscopy in Children and Young Adults With Portal Hypertension.
J Pediatr Gastroenterol Nutr
; 69(6): 641-647, 2019 12.
Article
em En
| MEDLINE
| ID: mdl-31365487
ABSTRACT
OBJECTIVES:
Variceal hemorrhage (VH) is a serious complication of portal hypertension (PH). We evaluated the feasibility, safety, and clinical impact of esophageal capsule endoscopy (ECE) in pediatric and young adult patients with known or suspected PH.METHODS:
Children and young adults with PH at Boston Children's Hospital (2005-2017) were offered ECE for variceal screening or surveillance. Patient histories, ECE findings, and clinical outcomes were reviewed retrospectively.RESULTS:
One hundred and forty-nine ECE studies were performed in 98 patients (57.1% male patients) using 3 ECE devices for variceal screening (66.5%) or surveillance (33.5%). Three readers interpreted the studies (88.3%, 10.3%, and 1.4%, respectively). Median age was 16 years (IQR 13.7-18.5). One hundred and three ECE studies involved patients <18 years (69.1%). Fifteen patients (29 ECE studies) had a gastrointestinal (GI) bleeding (GIB) history, 5 in the preceding 12 months.Sixty-two ECE studies (44.9%) detected varices 59 esophageal (40 small, 19âmedium/large), 17 gastric, 6 duodenal. Other findings included portal gastropathy (25, 18.1%), esophagitis (20, 14.5%), ulcers (5, 3.6%), erosions (31, 22.5%), heterotopic tissue (13, 9.4%), blood flecks (23, 16.7%), and mucosal scars (17, 12.3%). There were 2 transient capsule retentions and no major adverse events.ECE led to follow-up EGD in 11 (7 variceal banding) and medication initiation in 12 (4 proton-pump inhibitor, 7 nonselective beta blocker, 2 other) cases. Four patients had GIB within 12 months of ECE.CONCLUSION:
ECE is a feasible alternative to EGD for screening and surveillance of esophageal varices in children and young adults.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Varizes Esofágicas e Gástricas
/
Endoscopia por Cápsula
/
Hemorragia Gastrointestinal
/
Hipertensão Portal
Tipo de estudo:
Etiology_studies
/
Observational_studies
Limite:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article