The Role of Esophagogastroduodenoscopy in the Initial Evaluation of Childhood Inflammatory Bowel Disease: A 7-Year Study

Abstract

Endoscopic and histologic abnormalities were found in the upper gastrointestinal tracts of a significant number of children with inflammatory bowel disease. While the mechanism(s) underlying these abnormalities in patients with ulcerative colitis is unclear, the pathology can contribute to the patient's clinical condition. Pathology in the upper gastrointestinal tract should not exclude a diagnosis of ulcerative colitis. Granulomas, confirming the diagnosis of Crohn disease, were found in the upper gastrointestinal tracts of 28% of our patients with Crohn disease. In some cases, granulomas were found solely in the upper gastrointestinal tracts. Based on our data, esophagogastroduodenoscopy with biopsy should be performed in all pediatric patients with suspected inflammatory bowel disease.

Paediatric inflammatory bowel disease in a multiracial Asian country

“…(11) The high frequency of occurrence of upper gastrointestinal inflammation in our series is also consistent with that of previous reports (range 50%-64%). (34,35) These findings emphasise the importance of routine upper endoscopy in all children suspected of having IBD regardless of any upper gastrointestinal symptoms, as findings of aphthous ulcers or granulomas may help to confirm a diagnosis of CD, which might otherwise be missed. The high incidence of H. pylori colonisation in our patients was likely related to its high prevalence in the local population.…”

Single-balloon enteroscopy, magnetic resonance enterography, and abdominal US useful for evaluation of small-bowel disease in children with (suspected) Crohn's disease

“…Furthermore, there may be small-bowel disease in the absence of terminal ileum disease. 1,2 In 2004, the European Society of Pediatric Gastroenterology Hepatology and Nutrition IBD working group released the recommendation that every child with suspected IBD should undergo upper endoscopy, ileocolonoscopy, with biopsies, and, in all cases except in definite UC, imaging of the small bowel with enteral contrast medium (ie, fluoroscopic imaging that includes smallbowel follow-through). 3 Nowadays, major drawbacks of small-bowel follow-through are recognized to include significant exposure to ionizing radiation and rather low sensitivity for detection of active CD.…”

Inflammatory bowel disease in Indonesian children

“…12 Granuloma is a pathognomonic sign of CD, although it is only found in 28% cases. 13 In most cases, histological examination may differentiate between CD and UC. However in some cases, it is difficult to be classified, and therefore called indeterminate colitis.…”