Skip to main content

Advertisement

SpringerLink
Log in

The Use of a Patency Capsule in Pediatric Crohn’s Disease: A Prospective Evaluation

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

Capsule endoscopy (CE) retention remains a concern in patients with suspected or known Crohn’s Disease (CD).

Aim

The aim of this study was to evaluate the ability of a patency capsule (PC) to establish functional patency in pediatric patients with suspected or known, symptomatic IBD.

Methods

A prospective, single center study evaluating the impact of CE on CD management used PC to qualify patients for CE. Patients excreting an intact PC, usually within 40 h of ingestion, were able to undergo standard video CE. Excretion time, structural integrity and patient safety were evaluated.

Results

Eighteen patients (10–16 years of age; 9 male; 5 known CD, 3 indeterminate colitis, 1 ulcerative colitis, 9 suspected CD) ingested the PC. Fifteen patients excreted intact PC (mean 34.5 h), 12 patients within 40 h (range 9–60 h). Sixteen (89%) underwent subsequent CE successfully. CD was eventually diagnosed in all patients having PC transit ≥40 h, whereas CD was the diagnosis in 9/12 (75%) in those patients who passed the PC within 40 h. The mean time of passage for an intact PC was 34.7 h, the longest 60 h. There were no capsule retentions or adverse events.

Conclusions

The PC appears to be a useful screening tool for functional patency of the small bowel in suspected or known pediatric CD. Delayed passage of an intact PC requires careful interpretation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Triester SL, Leighton JA, Leontiadis GI, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn’s disease. Am J Gastroenterol. 2006;101:954–964.

    Article  PubMed  Google Scholar 

  2. Mishkin DS, Chuttani R, Croffie J, et al. ASGE technology status evaluation report: wireless capsule endoscopy. Gastrointest Endosc. 2006;63:539–545.

    Article  PubMed  Google Scholar 

  3. Mergener K, Ponchon T, Gralnek I, et al. Literature review and recommendations for clinical application of small-bowel capsule endoscopy, based on a panel discussion by international experts. Consensus statements for small-bowel capsule endoscopy. 2006/2007. Endoscopy. 2007;39:895–909.

    Article  CAS  PubMed  Google Scholar 

  4. Cheon JH, Kim YS, Lee IS, et al. Can we predict spontaneous capsule passage after retention? A nationwide survey to evaluate the incidence and clinical outcomes of capsule retention. Endoscopy. 2007;39:1046–1052.

    Article  CAS  PubMed  Google Scholar 

  5. Caunedo A, Romero J, Herrerias J. Patency and PC capsules. World J Gastroenterol. 2008;14:5269–5273.

    Article  Google Scholar 

  6. Cohen S, Simms C. Pediatric perspectives on patency: initial report of a pediatric trial employing the M2A PC with a single timer plug. J Pediatr Gastroenterol Nutr. 2005;41:501.

    Google Scholar 

  7. Pennazio M, Santucci R, Rodonotti E, et al. Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy. Report of 100 consecutive cases. Gastroenterol. 2004;126:643–653.

    Article  Google Scholar 

  8. Sears DM, Avots-Avotins A, Culp K, Gasvin MW. Frequency and clinical outcome of capsule retention during capsule endoscopy for GI bleeding of obscure origin. Gastrointest Endosc. 2004;60:822–827.

    Article  PubMed  Google Scholar 

  9. Spada C, Spera G, Riccioni M, et al. A novel diagnostic tool for detecting functional patency of the small bowel: the Given PC. Endoscopy. 2005;37(9):793–800.

    Article  CAS  PubMed  Google Scholar 

  10. Herrerias JM, Leighton JA, Costamagna G, et al. PC patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy. Gastrointest Endosc. 2008;67:902–909.

    Article  PubMed  Google Scholar 

  11. Arguelles-Arias F, Caunedo A, Romero J, et al. The value of capsule endoscopy in pediatric patients with a suspicion of Crohn’s disease. Endoscopy. 2004;36:869–873.

    Article  CAS  PubMed  Google Scholar 

  12. Sant’anna AM, Dubois J, Miron MC, Seidman EG. Wireless capsule endoscopy for obscure small-bowel disorders: final results of the first pediatric controlled trial. Clin Gastroenterol Hepatol. 2005;3:264–270.

    Article  Google Scholar 

  13. Antao B, Bishop J, Shawis R, Thomson M. Clinical application and diagnostic yield of wireless capsule endoscopy in children. J Laparoendosc Adv Surg Tech A. 2007;17:364–370.

    Article  PubMed  Google Scholar 

  14. Cohen SA, Gralnek IM, Ephrath H, et al. Capsule endoscopy (CE) impacts diagnosis, alters management of pediatric inflammatory bowel disease (IBD). A prospective study. Gastro. 2007;132:A443.

    Google Scholar 

  15. Thomson M, Fritscher-Ravens A, Mylonaki A, et al. Wireless capsule endoscopy in children: a study to assess diagnostic yield in small bowel disease in paediatric patients. J Pediatr Gastroenterol Nutr. 2007;44:192–197.

    Article  PubMed  Google Scholar 

  16. Moy L, Levine J. Wireless capsule endoscopy in the pediatric age group: experience and complications. J Pediatr Gastroenterol Nutr. 2007;44:516–520.

    Article  PubMed  Google Scholar 

  17. deAngelis GL, Fornaroli F, deAngelis N, Magiteri B, Bizzari B. Wireless capsule endoscopy for pediatric small-bowel diseases. Am J Gastroenterol. 2007;102:1749–1757.

    Article  Google Scholar 

  18. Ge ZZ, Chen HY, Gao YJ, Gu JL, Hu YB, Xiao SD. Clinical application of wireless capsule endoscopy in pediatric patients for suspected small bowel diseases. Eur J Pediatr. 2007;166:825–829.

    Article  PubMed  Google Scholar 

  19. Cohen SA, Gralnek IM, Ephrath H, et al. Capsule endoscopy may reclassify inflammatory bowel disease: a historical analysis. J Pediatr Gastroenterol Nutr. 2008;47:31–36.

    Article  PubMed  Google Scholar 

  20. Atay O, Mahajan L, Kay M, Mohr F, Kaplan B, Wyllie R. Risk of capsule endoscope retention in pediatric patients: a large single-center experience and review of the literature. J Pediatr Gastroenterol Nutr. 2009;49:196–201.

    Article  PubMed  Google Scholar 

  21. Given® PC Patency System User Manual, DOC-0375-01, April 2006; 38.

  22. U.S. Food and Drug Administration Center for Devices and Radiological Health. PC patency system and Pillcam platform with Pillcam SB capsules. (510 k Number K090557; approval September 28, 2009) Available at: http://www.accessdata.fda.gov/cdrh_docs/pdf9/K090557.pdf. Accessed February 10, 2010.

Download references

Acknowledgments

This research was supported in part by Given Imaging, Yoqneam, Israel.

Author information

Authors and Affiliations

  1. Children’s Center for Digestive Health Care, Children’s Healthcare of Atlanta, 993-D Johnson Ferry Road, Suite 440, Atlanta, GA, 30342, USA

    Stanley A. Cohen, Angela Stallworth & Tamara Wakhisi

  2. Rappaport Faculty of Medicine, GI Outcomes Unit, Department of Gastroenterology, Technion-Israel Institute of Technology, Rambam Health Care Campus, POB 9062, 31096, Haifa, Israel

    Ian M. Gralnek

  3. Given Imaging Ltd., Hermon Building, P.O. Box 258, 20692, Yoqneam, Israel

    Hagit Ephrath

Authors
  1. Stanley A. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ian M. Gralnek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hagit Ephrath
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Angela Stallworth
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tamara Wakhisi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stanley A. Cohen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cohen, S.A., Gralnek, I.M., Ephrath, H. et al. The Use of a Patency Capsule in Pediatric Crohn’s Disease: A Prospective Evaluation. Dig Dis Sci 56, 860–865 (2011). https://doi.org/10.1007/s10620-010-1330-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-010-1330-2

Keywords

Search

Navigation