Pediatric video capsule endoscopy: diagnostic yield, safety, and clinical impact in a tertiary center

Introduction: Video capsule endoscopy (VCE) enables direct, radiation-free visualization of the small bowel mucosa and is endorsed by pediatric guidelines as a key tool in the evaluation of Crohn's disease (CD). Despite this, VCE remains underused in routine pediatric practice, and its real-world clinical impact is insufficiently characterized. We aimed to assess the diagnostic yield, safety, and management consequences of pediatric VCE in a tertiary center and to compare its findings with cross-sectional imaging and biomarkers. Methods: We conducted a retrospective, single-center study of VCE procedures in children younger than 18 years performed between 2018 and 2024. Demographic, clinical, imaging, and laboratory data were reviewed to characterize indications, safety, and clinical yield. Results: = 0.07, 95% CI -0.19 to 0.34), underscoring the complementary value of VCE. Conclusion: VCE is a safe and well-tolerated modality for evaluating pediatric small bowel disease, particularly CD, and frequently reveals clinically relevant inflammation missed by conventional imaging. These findings support its broader integration into pediatric practice.