The role of endoscopic ultrasound in children with Pancreatobiliary and gastrointestinal disorders: a single center series and review of the literature

Fugazza, Alessandro; Bizzarri, Barbara; Gaiani, Federica; Manfredi, Marco; Ghiselli, Alessia; Crafa, Pellegrino; Carrà, Maria Clotilde; de’Angelis, Nicola; de’Angelis, Gian Luigi

doi:10.1186/s12887-017-0956-z

Cited by 21 publications

(24 citation statements)

References 38 publications

(76 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[3,4,32] Upper endoscopy was fundamental for the visualization of the mass and the histological diagnosis, and on its basis, it was possible to complete the staging by using EUS and imaging. [33] EUS allowed defining and confirming dimensions of the lesion, supporting upper endoscopy findings, but also permitted to detect 1 periduodenal lymph node suspicious for a metastatic lymph node. EUS was fundamental not only for the T staging, but also for the N staging.…”

Section: Discussionmentioning

confidence: 81%

Pediatric gastroenteropancreatic neuroendocrine tumor

et al. 2019

Self Cite

View full text Add to dashboard Cite

Introduction:Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a heterogeneous group of epithelial neoplasms originating from the diffuse neuroendocrine cell system of the gastrointestinal tract and pancreas. They are very rare, especially in pediatric age, and vary widely in terms of clinical presentation, malignant potential, and prognosis.Patient concerns:A 9 years’ old, white female child presented with abdominal pain and diarrhea mixed with bright red blood lasting 2 days followed by hematemesis.Diagnosis:Routine laboratory tests revealed microcytic anemia. Upper endoscopy showed a 20-mm polypoid lesion in the posterior wall of the duodenal bulb. Biopsy specimens were taken and histologic analysis showed a well-differentiated neuroendocrine tumor G1, with a ki-67 index <2%, an expression of chromogranine A (CgA), synaptophysin and somatostatin receptor type 2A (SSTR2A). Endoscopic ultrasound showed a 21-mm hypoechoic, hypervascular lesion involving the mucosal, submucosal, and muscular layers and a 15-mm hypoechoic round periduodenal lymph node. Gallium-68-somatostatin receptor positron emission tomography (PET with Ga-DOTATOC) showed one area of tracer uptake in the duodenum and other one near the duodenum compatible with the primary tumor site and a lymph node respectively. All the tests confirmed the diagnosis of a GEP-NET of the duodenal bulb, with a single lymph-node metastasis.Interventions:The patient underwent an open duodenal wedge resection.Outcomes:The follow-up at 6, 24, and 36 months and then yearly after surgery for a total of 42 months showed no evidence of recurrence.Conclusion:Duodenal neuroendocrine tumors represent 1% to 3% of all GEP-NETs. They are rare in adults and extremely rare in children. Therefore, the diagnostic and therapeutic approach should be multidisciplinary, including laboratory, endoscopic, and specific imaging tests and strictly follows guidelines, to avoid misdiagnosis and inadequate treatments. Although the prognosis is benign in most cases, they can present with metastases. Therefore, a careful follow-up is extremely important.

show abstract

Section: Discussionmentioning

confidence: 81%

Pediatric gastroenteropancreatic neuroendocrine tumor

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…EUS-FNA was performed in 92 (15.7%) cases achieving a diagnosis in 81 cases with an overall diagnostic accuracy of 88% (7 cases in our study with a diagnostic accuracy of 100%). Therapeutic EUS was performed in 16 cases (7 pancreatic pseudocyst drainage, 7 celiac plexus block, 1 EUS-guided transgastric biliary drainage[ 4 , 6 - 8 , 15 , 16 ] and 1 mediastinal bronchogenic cyst aspiration in our study). The incidence rate of EUS-related complications ranged between 1.96% and 7.1%; which was reported in only 4 studies[ 3 , 4 , 6 , 16 ].…”

Section: Discussionmentioning

confidence: 95%

“…Herein, we report the experience of a single tertiary center in the use of EUS and EUS-FNA in a pediatric population and compare the findings to the most relevant studies in the literature assessing the role of EUS in children (Table 3 ). A total of 12 studies[ 3 - 12 , 15 , 16 ] were published between 1998 and 2019 including 524 patients and 584 EUS procedures. The age of the enrolled patients ranged between 0.5 and 21 years.…”

Section: Discussionmentioning

confidence: 99%

“…EUS-FNA was performed in 7 patients and a definite diagnosis was achieved in all patients allowing them to undergo appropriate management (patients with pancreatic NET, SPN, and rectal GIST underwent surgery, those with mediastinal and abdominal lymphomas started chemotherapy, peri-gastric postpancreatitis collection resolved with antibiotics, and a mediastinal bronchogenic cyst was completely aspirated). A commonly reported therapeutic indication for EUS in pediatrics is the drainage of pancreatic fluid collections[ 4 , 15 , 16 ]. In the present study, the child who presented with a large mediastinal bronchogenic cyst (10 cm × 7.6 cm) underwent successful EUS-guided aspiration of the cyst content with no recurrence within 6 mo after aspiration.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Role of endoscopic ultrasound in pediatric patients: A single tertiary center experience and review of the literature

Altonbary

Hakim

Elkashef

2020

WJGE

View full text Add to dashboard Cite

BACKGROUND Although endoscopic ultrasound (EUS) is now widely available and has an established role in adults, the utility of EUS and EUS-guided fine needle aspiration (EUS-FNA) in pediatrics is insufficiently described compared to adults and is supported by only a few studies. AIM To report the experience of a single tertiary center in the use of EUS and EUS-FNA in a pediatric population and to further assess its safety, feasibility, and clinical impact on management. METHODS A retrospective study of 13 children (aged 18 years or younger) identified from our medical database was conducted. A retrospective review of demographic data, procedure indications, EUS findings, and the clinical impact of EUS on the subsequent management of these patients was performed. RESULTS During the 4-year study period, a total of 13 (1.7%) pediatric EUS examinations out of 749 EUS procedures were performed in our unit. The mean age of these 8 females and 5 males was 15.6 years (range: 6-18). Six of the 13 EUS examinations were pancreatobiliary (46.1%), followed by mediastinal 2/13 (15.4%), peri-gastric 2/13 (15.4%), abdominal lymphadenopathy 1/13 (7.7%), tracheal 1/13 (7.7%) and rectal 1/13 (7.7%). Overall, EUS-FNA was performed in 7 patients (53.8%) with a diagnostic yield of 100%. The EUS results had a significant impact on clinical care in 10/13 (77%) cases. No complications occurred in these patients during or after any of the procedures. CONCLUSION EUS and EUS-FNA in the pediatric population are safe, feasible, and have a significant clinical impact on the subsequent management; thus avoiding invasive and unnecessary procedures.

show abstract

“…According to the bibliography consulted, studies conducted by Laffita Estévez and collaborators [6], and Verdecia Cañizares [7] report that cancer in Cuba is a disease that has been increasing in recent years, with less frequency in the incidence of cancer of pancreas.…”

Section: Discussionmentioning

confidence: 99%