One Thousand Small-bowel Biopsies in Children A Single-Port versus a Double-Port Capsule

• Published in: Scandinavian journal of gastroenterology 2001, Vol.36 (11), p.1230-1232
• Main Authors: Högberg, L, Nordwall, M, Stenhammar, L
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anti-Anxiety Agents - administration & dosage; Biological and medical sciences; Biopsy - adverse effects; Biopsy - methods; Child; Child, Preschool; Children; Children Coeliac Disease Fluoroscopy Suction Biopsy; Coeliac disease; Diazepam - administration & dosage; Fluoroscopy; Humans; Hypnotics and Sedatives - administration & dosage; Infant; Intestine, Small - pathology; Malabsorption Syndromes - pathology; Medical sciences; MEDICIN; MEDICINE; Metoclopramide - administration & dosage; Midazolam - administration & dosage; Retrospective Studies; Stomach, duodenum, intestine, rectum, anus; Suction biopsy; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Time Factors; Trimeprazine - administration & dosage
• ISSN: 0036-5521; 1502-7708; 1502-7708
• DOI: 10.1080/00365520152584905

Background: Small-bowel biopsy is a well-established technique in the evaluation of children with intestinal malabsorption, e.g. coeliac disease. The biopsy is performed endoscopically or with a peroral capsule instrument. The aim of the present retrospective study was to compare the single-port Watson capsule with the double-port Storz capsule with regard to procedure and fluoroscopy time, complications and failure rate. Methods: All 1,078 peroral small-bowel biopsies performed at our department during 1989-99 were studied. In 387 of these, the Watson capsule was used and in the remaining 691 the Storz capsule. Median age of the children was 2.5 years. About one-third of the children were premedicated with the prokinetic drug cisapride and as sedatives alimemazine or diazepam orally. Two-thirds of the children were given metoclopramide along with midazolam intravenously. The biopsies were performed under intermittent fluoroscopy. Results: The median biopsy procedure time was significantly shorter with the Storz capsule (7 min) compared to the Watson capsule (10 min) ( P < 0.05). The median fluoroscopy time was 5 sec with the Storz capsule and 8 sec with the Watson capsule ( P < 0.01). The failure rate did not differ significantly between the two capsule types: 10.3% (Watson) and 7.7% (Storz). One potential but no serious complication occurred. Conclusions: Providing that effective sedation is available, smallbowel biopsy with a peroral capsule, and the Storz double-port multibiopsy capsule in particular, is a safe and fast method exposing the child to a minimal radiation dose.