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Diagnostic yield, safety, and efficacy of push enteroscopy in pediatrics

Anil Darbari1, Anthony N Kalloo, Carmen Cuffari

  • 1Department of Pediatrics, Division of Gastroenterology and Nutrition, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.

Gastrointestinal Endoscopy
|July 25, 2006
PubMed

Insights

Push enteroscopy is a safe and effective tool for diagnosing proximal small bowel diseases in children, with significant impact on treatment decisions. This pediatric enteroscopy method offers valuable diagnostic yield for conditions like Crohn's disease and bleeding.

Area of Science:

  • Pediatric Gastroenterology
  • Endoscopic Procedures
  • Small Bowel Diagnostics

Background:

  • Push enteroscopy has not been previously compared to standard endoscopy in pediatric populations.
  • Evaluating new endoscopic techniques is crucial for improving diagnostic capabilities in children.

Purpose of the Study:

  • To assess the feasibility, diagnostic yield, and safety of push enteroscopy in children with suspected proximal small bowel disease.
  • To compare push enteroscopy with standard endoscopy in the pediatric population.

Main Methods:

  • A retrospective database analysis of children undergoing push enteroscopy at The Johns Hopkins Children's Center (2001-2005).
  • Data collected included patient demographics, clinical history, indications for the procedure, and clinical utility based on therapeutic changes.
  • Diagnostic yield and safety were the primary outcome measures.

Main Results:

  • Push enteroscopy was performed on 44 children (median age 10 years) for suspected proximal small bowel disease or bleeding.
  • Diagnoses included Crohn's disease (23), polyps (5), eosinophilic gastroenteritis (4), and others. Many lesions were beyond the reach of standard esophagogastroduodenoscopy (EGD).
  • Clinical management was modified in 34 patients, demonstrating significant clinical utility. The procedure was safe with no significant impact on procedure time compared to EGD.

Conclusions:

  • Push enteroscopy is a safe and clinically useful diagnostic tool for children with suspected proximal small bowel disease.
  • Further research with larger studies is recommended to establish the broader application of push enteroscopy in pediatric care.
Abstract

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