Predicting pediatric esophageal wall thickness: An EUS study

Rabinowitz, Simon S.; Grossman, Evan; Feng, Lisa; Ebigbo, Nonyelum; Lin, Bo; Gupta, Raavi; Sklar, Rachel; Schwarz, Steven M.; Weedon, Jeremy; Gress, Frank G.

doi:10.4103/eus.eus_15_20

Cited by 12 publications

(7 citation statements)

References 19 publications

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“…The findings of a study showed that the thickness of mucosa and sub-mucosa and total wall thickness of the middle and distal esophagus increase as a function of the age and height of children. There was an insignificant difference between recorded values for central and distal esophagus, and the obtained values for control patients could be used for determining esophageal disease among children (26). We found no significant difference between the three groups regarding mucosal thickness in the cervical esophagus and diameter and length in the abdominal esophagus.…”

Section: Discussionmentioning

confidence: 49%

Diagnostic Value of Ultrasound Findings in Eosinophilic Esophagitis Versus Gastroesophageal Reflux Disease in Children

et al. 2022

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Background: Eosinophilic esophagitis (EoE) is a disease involving the esophagus due to an immune system reaction and has clinical symptoms similar to gastroesophageal reflux disease (GERD). Currently, the only definitive way to diagnose this disease is the endoscopy and biopsy of the esophageal tissue. Objectives: In this study, we investigated the diagnostic value of ultrasound to differentiate EoE from GERD and normal patterns. In addition, we assessed the possibility of replacing ultrasound with an invasive endoscopic method for the diagnosis and follow-up of EoE. Methods: This cross-sectional study was conducted on 4-12-year-old children in three groups of definitely diagnosed GERD, EoE, and healthy controls. Each group consisted of 30 participants who were evaluated for ultrasound parameters. The obtained values were compared between groups. The sensitivity and specificity of ultrasound findings were determined by receiver operating characteristic curve analysis. Results: Ultrasound findings, including wall thickness and distensibility of the cervical and abdominal esophagus, gastric wall thickness, and cervical esophagus diameter had significant differences between the three groups. The EoE group had the highest mean ± SD abdominal esophageal wall thickness of 2.73 ± 0.66 mm, gastric wall thickness of 4.30 ± 0.79 mm, and cervical esophageal wall thickness of 2.32 ± 1.21 mm. The GERD group had the lowest mean ± SD cervical esophagus diameter and distensibility of the abdominal esophagus. On the other hand, this group had the highest mean distensibility of the cervical esophagus. The highest area under the curve (AUC) for discriminating EoE from controls were 0.83 and 0.80 for gastric wall thickness and abdominal esophageal wall thickness, respectively. Moreover, the highest AUCs for discriminating EoE from GERD were 0.80 and 0.71 for gastric wall thickness and cervical esophageal wall thickness, respectively. Conclusions: Although the mean of ultrasound findings in the EoE group was significantly different from the control and GERD group, the ability to discriminate EoE from the control and GERD groups was moderate (0.70

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Section: Discussionmentioning

confidence: 49%

Diagnostic Value of Ultrasound Findings in Eosinophilic Esophagitis Versus Gastroesophageal Reflux Disease in Children

et al. 2022

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“…D-EUS tends to replace endoscopic retrograde cholangiopancreatography as a diagnostic tool for pancreatobiliary diseases, both in adults and children. EUS contributes to the diagnosis of conditions found only in children, such as congenital anomalies, solid pseudopapillary neoplasia, and certain anorectal disorders (13,26) . In the present study, 81 (76%) procedures were performed to evaluate pancreaticobiliary diseases (TABLE 2).…”

Section: Discussionmentioning

confidence: 99%

Impact of Diagnostic and Interventional Endoscopic Ultrasonography in Children

Garcia

Taglieri

Micelli-Neto

et al. 2022

Arq. Gastroenterol.

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Background: Endoscopic ultrasonography is used in the diagnosis and treatment of digestive diseases in adults. In children, its use is limited due to a lack of available expertise. Objective: This study aimed to evaluate the clinical impact of endoscopic ultrasonography on diagnostic and therapeutic strategy changes in pediatric patients. Methods: Over ten years, this study retrospectively and consecutively analyzed children aged ≤18 years who underwent endoscopic ultrasonography because of inconclusive imaging or laboratory tests. The indications, results, occurrence of adverse events, and clinical impact of the procedures were analyzed. The clinical impact was classified as major (when the findings led to changes in diagnosis and management), minor (change in diagnosis but not in management), or none (no change in diagnosis or management). Results: Overall, 107 children [77 (72%) of whom were female; mean age: 11.7 ± 4 years] underwent upper [102 (95.3%)] and lower [5 (4.7%)] endoscopic ultrasonography; 64 (58%) patients underwent diagnostic endoscopic ultrasonography, and 43 (42%) underwent interventional endoscopic ultrasonography. Endoscopic ultrasonography was used to investigate pancreaticobiliary, gastric, rectal, esophageal, duodenal, and mediastinal diseases in 81 (76%), 14 (13%), 5 (4.6%), 3 (2.8%), 2 (1.8%), and 2 (1.8%) patients, respectively. The clinical impact was significant in 81% of the children. Major and no clinical impact on pancreaticobiliary, gastrointestinal diseases, and mediastinal masses occurred in 50 (62%) and 13 (16%), 13 (54%) and 9 (37%), and 2 (100%) and 0 (0%) of the patients, respectively. Conclusion: This study evaluated the impact of diagnostic and interventional endoscopic ultrasonography in pediatric patients. When clinically and appropriately indicated, these procedures are safe and effective diagnostic or therapeutic interventions in pediatric patients with gastrointestinal or pancreaticobiliary disorders.

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“…However, for EUS to be employed in children as a tool to evaluate esophageal wall thickening, normal values of thickness need be obtained. The literature has unfortunately not provided reliable measurements as has been previously summarized 30 . Until the completion of puberty, a child's body will be growing, including the esophageal wall.…”

Section: Endoscopic Ultrasound In Eosinophilic Esophagitismentioning

confidence: 99%

Endoscopic Point of Care Ultrasound: Foundations, Present Applications, Future Potentials

Rabinowitz,

Sharma,

Grossman

2023

MRAJ

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Introduction: The present review details the evolution of endoscopic ultrasound, the acquisition of subepithelial imaging of the gastrointestinal tract during endoscopy, in pediatrics. Similar to its use in adults, the majority of its present applications involve obtaining fluid and or tissue for diagnosis. Simultaneously, the indications for point of care ultrasound, in which physicians caring for a patient personally obtains images which can be incorporated immediately into diagnosis and management, are also expanding. A history of endoscopic ultrasound from its inception to its current utilization is presented. The data reflecting its successful current employment as the procedure of choice to analyze and drain pancreatic cysts, to diagnose biliary tract and pancreatic diseases, to direct subepithelial biopsies, and to evaluate gastrointestinal tumors as well as less common gastrointestinal pathologies, is summarized with an emphasis on pediatric studies. In addition, the recent expansion of point of care ultrasound and endoscopic ultrasound to yield images to analyze subepithelial pathology including fibrosis in eosinophilic esophagitis and in inflammatory bowel disease is highlighted. A brief summary of the challenges, range of instruments, costs, and safety provides the reader with the background to fully appreciate this emerging technique. Finally, there is an overview of exciting new developments that will further extend its indications. Conclusions: With anticipated improvements including better resolution of endoscopic ultrasound probes, the routine incorporation of point of care elastography and contrast enhanced ultrasound, and the potential of artificial intelligence to provide more reproducible and uniform analysis of endosonographic images, new indications are anticipated to enable endoscopic point of care ultrasound, E-POCUS, to further improve patient care in the near future

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Predicting pediatric esophageal wall thickness: An EUS study

Cited by 12 publications

References 19 publications

Diagnostic Value of Ultrasound Findings in Eosinophilic Esophagitis Versus Gastroesophageal Reflux Disease in Children

Diagnostic Value of Ultrasound Findings in Eosinophilic Esophagitis Versus Gastroesophageal Reflux Disease in Children

Impact of Diagnostic and Interventional Endoscopic Ultrasonography in Children

Endoscopic Point of Care Ultrasound: Foundations, Present Applications, Future Potentials

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