Endoscopy Learning Library
Paediatric indications for colon capsule
Cesare Hassan 1, Cristiano Spada 2, Salvatore Oliva 3
1Endoscopia Digestiva, Ospedale Nuovo Regina Margherita, Roma 2Endoscopia Digestiva, Fondazione Policlinico Universitario “A. Gemelli”, Roma3Gastroenterologia Pediatrica, La Sapienza, Università di Roma
Despite colonoscopy still represents the gold-standard for diagnosis and treatment of colorectal diseases, like neoplasia and inflammatory conditions (IBD), it remains affected by a suboptimal compliance and tolerability. This is especially true in paediatric patients, where the need for the anaesthesiologist also increases the absolute costs of the procedure, and it is further worsened by the need of repeating frequently the assessment of colorectal mucosa in paediatric IBD. Colon capsule represents an innovative technology able to visualize the complete colorectal mucosa in most of the patients. In order to achieve such goal, the colon capsule requires a complex bowel preparation based on 4 liter of polyethilenglicole and 1-2 booster of sodium phosphate. Several studies have already shown a competitive accuracy of colon capsule as compared with colonoscopy for polyp detection. In the setting of IBD, that is more relevant in paediatric patients, colon capsule have shown a high accuracy in the diagnosis and staging of both ulcerative colitis and Crohn’s disease both in adult and paediatric subjects. A further improvement will be soon available, with a capsule able to image both the small and large bowel in the same procedure with preliminary favourable results.