Esophageal Capsule Endoscopy in Children
Condition: Portal Hypertension; Cirrhosis
MeSH terms: Hypertension, Portal; Hypertension
Study type: Interventional

Summary: 
      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.
    


Intervention name(s): Wireless esophageal capsule endoscopy ( PillCam Eso2)
Intervention type(s): Device
Intervention description(s): This is a simple blind (blind for the lecture of the capsule endoscopy record) study to evaluate the diagnostic value of the capsule endoscopy for the detection and the control of esophageal varices, the feasibility, tolerance and safety of the capsule endoscopy compared to the conventional EGD under general sedation in children presenting with portal hypertension.
During one week, the patients will undergo two exams (capsule endoscopy and EGD under general sedation). The exams will be done by two different physicians.
For to asses the tolerance, after they completed both exams, the patients will be asked to answer a "comfort score" questionnaire.
In order to asses the safety of the capsule endoscopy, the patients will be followed for adverse events during 3 weeks after the completion of the capsule endoscopy.
Other intervention name(s): PillCam Eso2
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: Esophageal varices; Portal hypertension in children; Wireless capsule endoscopy