A multicenter study of capsule endoscopy in preschool children in China

To evaluate the safety and clinical utility of capsule endoscopy in preschool-aged children. A multicenter retrospective study design was used, including data from eight specialized pediatric hospitals in China. Children aged < 6 years who were hospitalized and underwent capsule endoscopy between January 2020 and August 2025 were included. This study included 155 patients (mean age 56.9 ± 14.2 months). The most common indication was chronic abdominal pain (50.97%), followed by suspected inflammatory bowel disease (22.58%), gastrointestinal bleeding (16.13%), and unexplained anemia (8.39%). Abnormal findings were identified in 69 cases, which established a definitive diagnosis in 55 patients (diagnostic yield, 35.5%), including 15 with isolated small-bowel disease. Capsule retention occurred in three patients with Crohn’s disease. Fifty patients swallowed the capsule independently, while others required endoscopic placement; endoscopic assistance increased the success rate of capsule delivery to 100% in preschool children. When preschool children exhibited elevated inflammatory markers (C-reactive protein(CRP) 6 mg/L [interquartile range (IQR), 0.81-23 mg/L] vs. 0.95 mg/L [IQR, 0.51–3.58 mg/L]; erythrocyte sedimentation rate(ESR) 16 mm/h [IQR, 6–27 mm/h] vs. 7 mm/h [IQR, 4–14 mm/h]), lower albumin levels (38.47 ± 8.83 g/L vs. 42.50 ± 4.92 g/L), and intestinal wall thickening on imaging (56.36% vs. 20.00%), the diagnostic positive rate significantly increased. Capsule endoscopy is safe for preschool children. Capsule retention is mainly associated with underlying diseases. Capsule endoscopy is recommended to assess small-bowel lesions in children with elevated inflammatory markers, reduced albumin levels, or radiographic evidence of bowel wall thickening, facilitating early diagnosis and treatment.