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Diagnostic and therapeutic colonoscopy in children: experience from a pediatric gastroenterology centre in India
1Division of Pediatric Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh.
Insights
Colonoscopy effectively diagnoses pediatric colonic disorders, with juvenile polyps being the most common finding. This safe procedure allows for successful polyp removal, offering significant therapeutic benefits for children.
Area of Science:
- Pediatric Gastroenterology
- Endoscopy
- Colorectal Diseases
Background:
- Colonoscopies are crucial for diagnosing various colonic disorders in children.
- Indications include rectal bleeding, prolonged colitis, and colonic obstruction.
Purpose of the Study:
- To evaluate the safety and efficacy of colonoscopy in pediatric patients.
- To identify common colonic lesions and diagnoses in children.
Main Methods:
- Eighty colonoscopies were performed on 72 children using a pediatric colonoscope (PCF-Olympus) under sedation.
- Bowel preparation involved normal saline wash.
- Procedures were conducted by expert hands.
Main Results:
- Juvenile polyps were the most frequent lesions (69.4%), primarily in the rectosigmoid region.
- Other diagnoses included idiopathic ulcerative colitis (5.5%), acute colitis (4.2%), and tuberculous colitis (2.7%).
- Colonoscopic polyp removal was successful in 96% of cases with no observed complications.
Conclusions:
- Colonoscopy is a safe and valuable diagnostic tool for pediatric colonic disorders.
- It offers significant therapeutic potential, particularly for polyp management in children.
Abstract:
Eighty colonoscopies were performed in 72 children suffering from various colonic disorders. The indications for colonoscopic examination were bleeding per rectum (83.3%), prolonged colitis (14.0%) and colonic obstruction (2.7%). Total bowel wash with normal saline was very good for colonic preparation in majority of the cases. Pediatric colonoscope (PCF-Olympus) was used and the procedure performed under sedation with intravenous diazepam and pentazocine. Juvenile polyps were the commonest lesions (69.4%). Diagnosis of idiopathic ulcerative colitis, acute colitis, tuberculous colitis, amebic colitis and allergic colitis was made in 5.5, 4.2, 2.7, 1.3 and 1.3% cases, respectively. Tuberculous hypertrophic lesion and tuberculous stricture was seen in one case each. The commonest site of juvenile polyps was rectosigmoid region. Ninety per cent of them were single, 8% had polyps ranging from 2-4 in number and one (2%) child had juvenile polyposis coli. Successful colonoscopic removal of polyps with polypectomy snare was possible in 96% cases. No complications were observed. Colonoscopy is a safe and useful mode of investigation of colonic disorders in expert hands. It has a great therapeutic value in childhood.
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