Wireless capsule endoscopy for obscure small-bowel disorders: Final results of the first pediatric controlled trial Ana Maria Guilhon de Araujo Sant’Anna,

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Wireless capsule endoscopy for obscure small-bowel disorders: Final results of the first pediatric controlled trial Ana Maria Guilhon de Araujo Sant’Anna, Josée Dubois, Marie-Claude Miron, Ernest G. Seidman Clinical Gastroenterology and Hepatology Volume 3, Issue 3, Pages 264-270 (March 2005) DOI: 10.1016/S1542-3565(04)00715-3 Copyright © 2005 American Gastroenterological Association Terms and Conditions

Figure 1 Capsule endoscopic image showing a typical focal ulceration of the small bowel, compatible with Crohn’s disease. The patient is an adolescent who presented with abdominal pain and diarrhea. Despite a high clinical index of suspicion for Crohn’s disease, colonoscopy with multiple colonic and ileal biopsy examinations were normal, as was barium study of the upper gastrointestinal tract and small bowel. The capsule study showed multiple superficial, fibrin-covered ulcerations dispersed in the jejunum, as well as others in the proximal ileum (not shown). Clinical Gastroenterology and Hepatology 2005 3, 264-270DOI: (10.1016/S1542-3565(04)00715-3) Copyright © 2005 American Gastroenterological Association Terms and Conditions

Figure 2 Capsule endoscopic image showing the focal nature of the mucosal lesions in eosinophilic enteropathy. The patient presented with a protein-losing enteropathy and chronic iron-deficiency anemia. (A) A clearly demarcated area of complete villous atrophy with erythema is seen alongside an area covered with normal-appearing villi. (B) Capsule endoscopic image showing a focal small-bowel stricture in a patient caused by eosinophilic gastroenteropathy. One of 3 strictures found by capsule study in the same patient is shown. These strictures were not seen on a recent barium examination of the small bowel. The capsule was retained, without symptoms, for several days. Treatment with corticosteroids successfully relieved the inflammatory stenosis, with uncomplicated passage of the capsule. Clinical Gastroenterology and Hepatology 2005 3, 264-270DOI: (10.1016/S1542-3565(04)00715-3) Copyright © 2005 American Gastroenterological Association Terms and Conditions

Figure 3 Capsule endoscopic image of a small-bowel polyp in an adolescent with Peutz-Jegher syndrome. This polyp was missed by barium and endoscopic studies. Clinical Gastroenterology and Hepatology 2005 3, 264-270DOI: (10.1016/S1542-3565(04)00715-3) Copyright © 2005 American Gastroenterological Association Terms and Conditions