{
  "abstract": "Video capsule endoscopy (VCE) is widely used for the evaluation of small bowel pathology in children. 1 Important indicators of procedure quality include whether the capsule reaches the caecum, confirming complete small bowel assessment and the quality of bowel preparation, which determines how clearly the mucosa can be evaluated on captured images.2 Small bowel transit time (SBTT), defined as the time from duodenal entry to caecal exit, provides further information on the flow of the procedure and can influence both interpretation and study duration.3 Our standard bowel preparation protocol consists of fasting from solids for approximately 16 hours prior to capsule ingestion with ample clear fluids given. No laxatives or prokinetics are used. Despite increasing use of VCE in children, real-world data describing capsule performance and the effect of bowel preparation quality remain limited.A retrospective review of 43 consecutive video capsule endoscopy procedures performed in a tertiary paediatric centre over a 10-month period (December 2024-September 2025) was undertaken. Each study was examined to determine whether the caecum was visualised. SBTT was recorded in minutes and hours. Bowel preparation quality was categorised during reporting as good or poor/limited, based on mucosal visibility. Studies were classified as failed if the caecum was not seen or if capsule passage beyond the small bowel was uncertain. Capsule retention was defined as persistence of the capsule beyond two weeks or the need for endoscopic or surgical retrieval.The capsule reached the caecum in 81.4% (35/43) of studies, while 18.6% (8/43) were incomplete due to non-visualisation or uncertainty regarding passage. Among completed studies, the mean SBTT was 4.68 hours (281 minutes) with a range of 1.73 to 9.75 hours, falling within normal paediatric SBTT of 227 to 332 minutes(1). Bowel preparation was judged to be good in 72.1% (31/43) of procedures, while 27.9% (12/43) had poor or limited preparation. Poor bowel preparation appeared more frequently in procedures that did not achieve completion. Older age was significantly associated with incomplete studies (median age 16 vs 14 years, p = 0.038). There were no cases of capsule retention, mostly secondary to careful patient selection with pre-procedure MRI and use of patency capsules.These findings show that VCE in this paediatric cohort achieved an acceptable completion rate above 80%. However, the failure rate of 18.6% was higher than the 0.4% to 4% reported in other paediatric studies.1 2 Older age was significantly associated with incomplete studies, suggesting possible poor adherence to booster fluids. Strategies to optimise bowel preparation and enhance procedural reliability may improve completion rates and diagnostic yield. Following this study, our centre has revised its protocol to include longer fasting periods and increased booster fluid volumes, with repeat audit planned in one year.References Wu J, Huang Z, Wang Y, et al. Clinical features of capsule endoscopy in 825 children: a single-center retrospective cohort study. Medicine (Baltimore). 2020;99:e22864.Oikawa-Kawamoto M, Sogo T, Yamaguchi T, et al. Safety and utility of capsule endoscopy for infants and young children. World J Gastroenterol. 2013;19:8342–8348.Rao SS, Camilleri M, Hasler WL, et al. Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European neurogastroenterology and motility societies. Neurogastroenterol Motil. 2011;23:8–23.Abstract OC18 Table 1VariableResultCompletion rate81.4% (35/43)Failure rate18.6% (8/43)Mean small bowel transit time4.68 hours (281 minutes)Bowel prep judged good72.1% (31/43)Capsule retention0%",
  "authors": [
    {
      "affiliations": [
        "King’s College Hospital, Paediatric Gastroenterology"
      ],
      "name": "Sorcha Mullen"
    },
    {
      "affiliations": [
        "King’s College Hospital, Paediatric Gastroenterology"
      ],
      "name": "Kirn Sandhu"
    },
    {
      "affiliations": [
        "King’s College Hospital, Paediatric Gastroenterology"
      ],
      "name": "Enes Coskun"
    },
    {
      "affiliations": [
        "King’s College Hospital, Paediatric Gastroenterology"
      ],
      "name": "Babu Vadamalayan"
    }
  ],
  "title": "OC18 Real-world performance of paediatric video capsule endoscopy: completion rates, small bowel transit times and the influence of bowel preparation quality",
  "uid": "b0d893db-5e37-5d52-9c41-78e22d761669"
}