USEFULNESS OF THE NEW 360° PANORAMIC-VIEWING CAPSULE ENDOSCOPY IN PEDIATRIC DISORDERS

Background & Aims: CapsoCam (CapsoVision Inc, Saratoga, USA) is a new small bowel capsule (SBC) with “panoramic lateral view”, wire-free technology, and long-lasting recording time. It is equipped with 4 high frame rate cameras (3-5 frames/second/camera), located at the side of the capsule. Previous studies in adults, comparing this device with frontal view SBCs, showed comparable operative and diagnostic performance. There are no data in children on this technology. This is the first, single center, observational study to assess the performance of CapsoCam in children. Methods: Between January 2016 and November 2017, consecutive children undergoing SBC with CapsoCam in single referral pediatric gastroenterology center were enrolled. All patients underwent an extensive work-up, with upper and lower gastrointestinal endoscopy. MRE was performed in all patients with suspected or established Crohn’s disease (CD). Results: Twenty-nine patients underwent SBC (median age 12 years; range 9-18). 7 (24%) were referred for suspected CD of the small bowel (SB), 15 (52%) for established CD and 7 (24%) for OGIB (3 with overt and 4 with occult GI bleeding). No technical failure was recorded. All patients excreted and retrieved the capsule. In two children the SBC was deployed endoscopically, due to the inability to swallow the capsule. The overall diagnostic yield (rate of positive tests) was 62%: 5/7 (71%) for OGIB, 3/7 (43%) for suspected CD, and 10/15 (67%) for established CD (Table 1). The capsule explored the entire SB in 93% of patients. All of the recognized OGIB lesions were located in the SB: 2 angiodysplasia, 2 polyps and 1 anastomotic ulcer. In those with established CD (n Z 15), SB lesions were revealed by MRE in 7 and by SBC in 10 patients, respectively. Of 7 patients with suspected IBD, SB lesions typical of Crohn’s disease were observed in 3 with SBC vs 1 with MRE. The SBC identified upper and/or lower GI tract lesions in 36% of patients with suspected or established CD. Bowel preparation was adequate in 86% of the procedures. No serious adverse event was recorded during the study. Twenty-seven (93%) of patients considered SBC tolerable and would undergo the procedure again. Conclusions: This first observational pediatric study suggests that CapsoCam is a safe and tolerable procedure in children, with a detection rate comparable to other SBC with frontal view. Further studies are necessary to explore and expand the capabilities and usefulness of this device.