This journal is
indexed in Scopus
Year 2017 Vol. 25 No 1
EXCHANGE OF EXPERIENCE
ENTEROSCOPY IN CROHN'S DISEASE IN CHILDREN WITH CONSISTENT APPLICATION OF SOLUBLE AND ENDOVIDEO CAPSULES
EE "Belarusian State Medical University",
The Republic of Belarus
Objectives. To demonstrate the effectiveness of endovideocapsule enteroscopy in children with Crohn’s disease by preliminary use of a soluble capsule to assess the intestinal patency and therapy monitoring.
Methods. The endoscopic method for diagnosing of the small intestine patency with using a soluble capsule «PillCam patency» and subsequent enteroscopy using endovideocapsule «PillCam» in children with Crohn’s disease had been applied. This article describes two clinical observations of patients with Crohn’s disease; a continuous migration of the capsule due to the presence of strictures of the small intestine took place in one of thîse patients.
Results. The two-stage endoscopic examination of children with Crohn’s disease is justified using clinical examples: at the first stage the intestinal patency is checked using a soluble capsule, if the intestine is passable, at the second stage enteroscopy using endovideocapsule is carried out.
The delay of endovideocapsule migration during the examination has been established to be possible. It does not require an active intervention if a patient has no signs of intestinal obstruction. However, in case of the capsule migration delay, the patient must be dynamically observed in the surgical hospital. In our observation the capsule remained in the small intestine over 7 months with subsequent spontaneous elimination. One of the effective diagnostic methods of capsule delay is the performance of a plain abdominal X-ray, since the capsule batteries are radiopaque.
Conclusion. One of Crohn’s disease complications in children can be a narrowing of the small intestine lumen and its patency, so prior the endovideocapsule enteroscopy the intestinal patency should be checked. The unimpeded migration of a soluble capsule is thought to be a basis for the subsequent capsule endoscopy. In case of endovideocapsule delay in the intestine and preservation passage of the intestinal contents it is necessary to ensure patient’s clinical dynamic observation until the elimination of the capsule.
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220116, the Republic of Belarus,
Minsk, Dzerzhinsky Ave., 83,
Department of pediatric surgery.
Tel.: +375 029 32-902-32
Alexander N. Voronetsky
Voronetsky A.N. PhD, Ass. Professor of the pediatric surgery department, EE "Belarusian State Medical University".