Esophageal Capsule Endoscopy in Children
Esophageal Capsule Endoscopy in Children
The portal hypertension (PHT) is the main complication in patients presenting with cirrhosis.
 It can be the direct cause of bleeding by rupture of the esophageal or gastric varices and
 can also contribute to the development of ascites, hepatic encephalopathy and pleuropulmonary
 complications.

 In the paediatric population presenting with the PHT, one of every two children develops
 varices and thus has a significant risk of bleeding. Safe and easy to use, the video capsule
 endoscopy (VCE) is now routinely used in children for the exploration of the small bowel. But
 the role of the VCE for examination of the other parts of digestive tract still needs to be
 evaluated.

 For the esophagus, the VCE could allow the diagnosis without the need of general sedation.
 Recent studies have shown a good sensitivity and tolerance of this technique for the initial
 diagnosis of esophageal varices (EV) in adult patients presenting with portal hypertension,
 but it has not yet been validated for this indication.

 The investigators hypothesize that the VCE could be used in children with similar results in
 term of efficacy, as for adults.

 This prospective simple blind multicentre study (blind for the lecture of the capsule
 endoscopy record), will investigate the diagnostic value of the VCE compared to the
 conventional esophagogastroduodenoscopy (EGD) under general sedation for the detection and
 the control of esophageal varices in children.

 If it is provided that the VCE is as efficient as it is for the adults, it could become a
 very interesting alternative to the conventional EGD because less expensive and less
 invasive. Moreover, this technique would be very useful as a means of early detection on the
 EV and/or their control.
Inclusion Criteria:

 -  patients between 7 and 18 years old

 -  presenting a portal hypertension and/or cirrhosis

 -  patients who are referred for a conventional EGD under general sedation

 -  patients who are not participating in other clinical studies

 -  written informed consent obtained from the patient and his/her legal guardians.

 Exclusion Criteria:

 -  patients presenting a contra indication for upper endoscopy or for the ingestion of
 the video capsule, especially those with clinical or radiological suspicion of upper
 gastrointestinal strictures (esophageal surgery or eosinophile esophagitys)

 -  patients presenting with dysphagia or gastrointestinal tract strictures (patients with
 Crohn's disease, small bowel carcinoma, stenosis due to the chronic use of a NSAI
 medication, acute necrotizing enterocolitis or prior abdominal surgery of the
 gastrointestinal tract); swallowing disorders with or without impaired consciousness;

 -  patients under calcium channel blocking agents medication;

 -  patient presenting with diverticulosis (Marphan's or Ehlers Danlos's syndrome)

 -  patients with cardiac pacemaker or other implanted electro medical device

 -  patients scheduled for a magnetic resonance imaging (MRI) examination within 7 days
 after ingestion of the capsule (and until the capsule is evacuated)

 -  any other life-threatening conditions.