Recent advances in pediatric gastrointestinal endoscopy: an overview

Abstract

Pediatric gastrointestinal endoscopy has become a fundamental component of health care for infants and children. New imaging technologies and creative extraluminal applications have brought exciting and clinically important benefits to pediatric gastrointestinal endoscopy. Areas covered: The impact of different new technologies in pediatric endoscopy and focused on improvements in mucosa visualization and the application of new noninvasive tools and procedures to avoid biopsies or surgery are reviewed. Expert commentary: Enhancement in mucosal visualization and reduction of anesthesia and biopsies are the main goals that guide the endoscopy development in pediatrics. The advent of newer imaging modalities has allowed clinicians to characterize and evaluate subtle mucosal lesions better, while advancements in current endoscopes have created the opportunity to monitor chronic conditions noninvasively. Continued expansion of these modalities seems certain, with increased utilization in pediatric gastroenterology.

Can a transition clinic bridge the gap between paediatric and adult inflammatory bowel disease care models?

“…Moreover, endoscopy requires deep sedation in children (some countries use general anaesthesia depending on age), while conscious sedation is generally used in adults. Indeed, it is paramount to consider the potential negative effects and the risks of repetitive deep sedation or general anaesthesia, by balancing the need of endoscopy in the decision-making process, especially in younger children with a severe disease course who are also generally reluctant to take the bowel preparation because of poor palatability, bloating or nausea [13] Whereas the aims of mucosal healing, deep remission and improved quality of life do not differ between paediatric and adults, the major aim in paediatric patients is to ensure growth and pubertal development. In addition , adult care is focused on surveillance, sexual function, fertility and pregnancy [14,15], while few childhood-onset colorectal cancers associated with IBD have been reported, so surveillance does not play a prominent role in paediatric care.…”

Endoscopy in Pediatric Inflammatory Bowel Disease

“…The challenge to use more minimally invasive endodiagnostic tools in children will be maintained going forward (233). Use of these tools will be weighed against their lack of tissue histology (59).…”

Systematic review and meta-analysis of the incidence rates of adverse events after digestive endoscopy in children

“…New colon capsule endoscopy (CCE) achieved sensitivity and specificity of 96% and 100% in monitoring and evaluating ulcerative colitis in children, respectively (7). EUS is an effective means for diagnosing perianal rectal abnormalities, congenital muscular hypertrophy, lymphoma, and polyposis in children (8).…”