Abstracts submitted to ASGE 2010
M1562: Use of Esophageal Capsule Endoscopy in Pediatric Patients With Portal Hypertension

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Introduction

Esophageal capsule endoscopy (ECE) has been reported to be an effective and comparable method to EGD in adult patients for the evaluation of esophageal varices. EGD is the preferred method for evaluating pediatric patients with portal hypertension for varices, and there is limited data on the use of ECE in this population. This population is more likely to have EGD for the evaluation of varices under general anesthesia, and due to concomitant coagulopathy and thrombocytopenia, is more likely to receive blood products. We evaluated ECE in a subset of pediatric patients with cirrhotic and non-cirrhotic portal hypertension.

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Methods

From 2008 to 2009, 11 pediatric patients (7F/4M) with portal hypertension underwent ECE, ages 12-18 (median 15). All patients underwent ECE according to PillCam ESO2© instructions. Indications included portal hypertension related to CF related liver disease (n=3), biliary atresia (n=2), autoimmune hepatitis (n=2), PFIC (n=1), drug-induced hepatotoxicity (n=1), hepatoblastoma (n=1), and cavernous portal vein transformation (n=1). Platelet counts ranged from 32,000-133,000 with 6 patients with a

Results

ECE was performed successfully in 10/11 patients with one patient unable to swallow the capsule. In the 10 patients, the mean capsule esophageal time was 45s (range 9-171s). One patient was determined to have no varices, and 4 patients had small varices. Four patients had both small and large varices present, and 1 patient had multiple large varices. All 5 patients who had temporal EGDs correlated with ECE findings revealing varices of all three grades. By ECE, one patient had linear esophageal

Conclusions

Our results suggest that ECE is a useful modality in the surveillance of esophageal varices. Future studies are needed to determine if ECE may reduce the number of anesthesia sessions, use of blood products, risk and cost associated with endoscopy and anesthesia in high-risk pediatric patients with portal hypertension.

Reference (1)

  • R. de Frannchise

    Esophageal capsule endospcopy for screening and surveillance of esophageal varices in patients with portal hypertension

    Hepatology

    (2008)

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