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[Prospective evaluation of the safety and tolerance of colonoscopy in children]
Juan Cristóbal Gana A1, Constanza Glenz A, Pamela Marchant A
1Departamento de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Insights
Pediatric colonoscopy is a feasible ambulatory procedure with intravenous sedation, showing minimal adverse effects. This study evaluated preparation, sedation, and outcomes in children undergoing lower endoscopy.
Area of Science:
- Pediatric Gastroenterology
- Endoscopy
- Clinical Pediatrics
Background:
- Colonoscopy is a standard diagnostic and therapeutic tool in pediatric care.
- Evaluating pediatric colonoscopy involves assessing preparation methods, sedation techniques, and clinical outcomes.
- Understanding indications and findings is crucial for effective pediatric gastrointestinal care.
Purpose of the Study:
- To assess colon preparation alternatives for pediatric colonoscopy or sigmoidoscopy.
- To evaluate the types of sedation used, clinical indications, and findings in pediatric lower endoscopies.
- To analyze the feasibility and safety of ambulatory colonoscopy in children.
Main Methods:
- A prospective study included 123 children undergoing colonoscopy.
- Data collected included demographics, colon preparation, sedation, and endoscopic results.
- Post-procedure phone interviews assessed sedation/procedure quality and adverse effects.
Main Results:
- The primary indication for colonoscopy was lower gastrointestinal bleeding (71%).
- Colon preparations yielded clear liquid stools in 50% of patients; common side effects included abdominal distension and nausea.
- Sedation was rated good/very good in 77%, with good/very good visualization in 87%; vomiting was the most common adverse effect (7.5%).
Conclusions:
- Lower endoscopies are feasible for children on an ambulatory basis.
- Intravenous sedation is effective with minimal adverse effects in pediatric colonoscopy.
- Colonoscopy in children is a safe and effective procedure for diagnosis and therapy.
Background:
Colonoscopy is a well established diagnostic and therapeutic procedure in pediatrics.
Aim:
To evaluate colon preparation alternatives for colonoscopy or sigmoidoscopy, type of sedation, clinical indications and findings.
Patients And Methods:
Prospective study of 123 children referred for colonoscopy. Demographic data, type of colon preparation, sedation, type of endoscope and endoscopic results were obtained. The following day, a phone interview was carried out inquiring about duration, quality and adverse effects of the sedation and procedure.
Results:
Seventy one boys (58%) and 52 girls (42%) with a mean age of 6.7+/-4.4 years, were recruited. The main indication was lower gastrointestinal bleeding (71%). The different colon preparations produced elimination of clear liquid stools in 50%, non transparent liquid in 23%, semi liquid in 22% and solid in 6% of the patients. Most common side effects were abdominal distension (20%) and nausea (16.8%). The most commonly used drugs were midazolam (76%) and demerol (43%). The average duration of the procedure was 18.3 minutes (range: 4-50). The most common findings were rectal polyps (18.7%) and hemorrhagic colitis (14.6%). In 77% of cases, the sedation was considered very good or good. Colon visualization was described as very good (51%) or good (36%). Seventy three percent of children had complete amnesia. The most common adverse effect was vomiting (7.5%).
Conclusion:
Lower endoscopies are feasible procedures to carry out in children, in an ambulatory basis, with intravenous sedation and minimum adverse effects.
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