WIRELESS CAPSULE

ENDOSCOPY FOR OBSCURE

SMALL-BOWEL
DISORDERS: FINAL RESULTS OF
THE FIRST PEDIATRIC
CONTROLLED TRIAL
ANA MARIA et.al.
PRESENTED BY E.SUNDARA
BHARATHI
M.Sc Nursing 2nd year
SMVNC

INTRODUCTION
PURPOSE OF STUDY:
To Diagnose the obscure
small-bowel
disorders
are
jejunal
and
ileal
lesions
undiagnosed by traditional
imaging
techniques
(endoscopic, radiologic). We
evaluated
the
diagnostic
usefulness
and
safety
of

INTRODUCTION CONTI
SUMMERY OF STUDY :
Capsule endoscopy
correctly
diagnosed
or
excluded a bleeding source,
small-bowel
polyps,
or
Chrohn's disease of the small
bowel
Capsule
endoscopy
permits
an
accurate,
noninvasive
approach
for

REVIEW OF LITERATURE
M.MYLONAKI et.al. (2003)
Wireless capsule endoscopy; a
comparison with gastroscopy
and negative gastrointestinal
bleeding.
P.SWAIN 2003 Small bowel
endoscopy and colonoscopy are
uncomfortable
because
they
require
comparatively
large
diameter flexible cables to be

PROBLEM
Self controlled trials in
patients
(age,
1018
Years)
suspected to have either smallbowel Chrohn's disease, polyps,
or obscure gastrointestinal (GI)
bleeding. Capsule results were
compared with the diagnostic
imaging studies normally used in
this age group.

METHODOLOGY
The study design was a
comparative and
prospective
self-controlled trial in
pediatric patients

PROCEDURE
Wireless capsule endoscopy
was performed using the capsule. The
capsule swallowed by the child.
The recording system is composed of
a data recorder and a workstation
equipped
with
image
processing
software are present in the capsule.
The capsule transmits 2 images per
second over the course of the battery
life, lasting approximately 8 hours.

PROCEDURE

Conti

The images are transmitted via a digital

radio frequency communication channel to
the recorder unit. The lens has a resolution of
.1 mm and a focal point of only 1 mm,
visualizing the small-bowel mucosa.
The portable data recorder consists of sensor
array electrodes that are attached to the
abdomen and a receiver located in a belt
worn by the child. On completion of the
examination,
the
physician-interpreter
transfers the accumulated data in the
recorder.

Capsule
Endoscopy and Traditional
Endoscopic and
Radiologic Tests for Obscure Small
Bowel
GROUPDisorders
LESIONS
LESIONS
in Children
Inflammatory /
chrohns
Disease and
esinogastroent
eropathy

Poliposis
(total
number of

IDENTIFIED BY
CAPSULE

IDENTIFIED BY
OTHER TEST

12

60% 5(21)

25% 5(14)

Capsule endoscopic image

showing a typical focal
ulceration
of the small bowel

Capsule endoscopic image

showing the focal nature of
the mucosal lesions in
eosinophilic enteropathy

Capsule endoscopic image of a

small-bowel polyp in an
adolescent

DISCUSSION
The small bowel has been
considered the last frontier of endoscopy,
a noninvasive diagnostic technique Up to
50% of cases of occult GI bleeding, one
third to one half of patients. Rebleed
Angiography and Radio nuclide scanning
are sensitive only in the presence of
active
bleeding.
Radiologic
misinterpretation
or
false-negative
examinations result in the longest delays
in diagnosis. diagnosis in 10 of 20 (50%)
of the patients of chrohn's disease

CONCLUSION
Capsule endoscopy correctly
diagnosed or excluded a bleeding
source, small-bowel polyps, or
Chrohn's disease of the small
bowel
in
Capsule
endoscopy
permits an accurate, noninvasive
approach for diagnosing obscure
small bowel lesions in children
over the age of 10.