Diagnostic Endoscopy in Children of Two Months to 15 Years of Age

Abstract

Problem statement: Considering high prevalence of gastrointestinal complaints in children and the important role of endoscopy in the diagnosis of such complaints, this study was designed to characterize the clinical, endoscopic and pathologic features of Iranian children undergoing upper Gastrointestinal (GI) endoscopy. Approach: This prospective study was performed in an office-based setting in a private medical centre in Kerman, Iran, between December 2004 to January 2008. Three hundred forty pediatric patients who underwent upper endoscopy for dyspeptic symptoms or other reasons were enrolled into this study and data were gathered concerning age, sex, reason of endoscopy, endoscopy report and pathologic report. Upper GI endoscopy was performed using Pentax video endoscope. Results: The most prevalent reason of performing endoscopy (43.1%) was abdominal pain. More than half of the cases with abdominal pain (54%) were in the age range of 5-10 year old of whom 80% had an abnormal pathologic finding such as esophgitis and active chronic gastritis associated with helicobacter pylori. The most common endoscopic finding (31.2%) and pathologic finding (40.3%) was esophagitis. More than half of the children with esophagitis (56.6%) had some degrees of hiatal hernia. In 35.5% of children with nodular gastritis, simultaneous esophagitis was observed. The rate of normal endoscopies and pathologies were respectively 10.8 and 19.4%. Conclusion: Considering low rate of normal endoscopic and pathologic reports in the studied subjects and also the variety of gastrointestinal complaints in them, it seems that proper selection of patients for undergoing upper GI endoscopy can have a significant directive role in the diagnosis of pediatric problems.

Pediatric Endoscopy in Calabar, an Emerging Trend – Challenges and Prospects: A Report of Two Cases.

“…Pediatric endoscopy is an emerging field in Nigeria and data on this subject is presently scanty. Upper gastrointestinal endoscopy still remains the gold standard for the diagnosis of diseases of the upper gastrointestinal tract (GIT) even in children [1][2][3][4]7,8,9 .Pediatric gastroscopy like in adults, offers both diagnostic and therapeutic benefits though special instrumentation and training may be required in children [1][2][3][4]12 . Generally, equipment necessary for diagnostic and therapeutic endoscopy in children older than 1-3 years of age and weighting more than 10 to 15kg are generally identical to that used in adults.…”

“…However, toddlers and infants require smaller endoscopes that have smaller working channels 12 . In adult gastroscopy, both physicians and surgeons carry out these procedures but there is paucity of pediatric endoscopist in Nigeria and other developing countries compared to the western world [7][8][9] .…”

“…Upper gastrointestinal endoscopy has been the gold standard for the diagnosis of diseases of the upper GI tract for several years now [1][2][3][4] . Majority of the reports on gastroscopy in the literature is among the adult populationwith reports in the pediatric age group being very scanty [7][8][9] . This has made experience in pediatric endoscopy very limited, especially in Nigeria.…”