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[Fiber-optic endoscopy of the lower gastrointestinal tract in children]
Insights
Pediatric colonoscopy effectively diagnoses lower gastrointestinal issues like rectal bleeding and colitis. Experienced endoscopists improve diagnostic accuracy, making it a safe and valuable procedure for children.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Procedures
- Diagnostic Medicine
Context:
- Rectal bleeding is a common pediatric concern requiring accurate diagnosis.
- Lower gastrointestinal endoscopies are crucial for identifying causes such as colitis and polyposis.
- Evaluating treatment outcomes necessitates thorough endoscopic examinations.
Purpose:
- To assess the diagnostic yield and safety of lower gastrointestinal endoscopy in children.
- To determine the efficacy of colonoscopy in identifying various pediatric gastrointestinal conditions.
- To analyze the accuracy of colonoscopic findings compared to histopathology.
Summary:
- Over 565 pediatric lower gastrointestinal endoscopies were performed between 1978-1985.
- Common findings included inflammatory changes (554 cases) and colon polyps (66 cases) as causes of rectal bleeding.
- Colonoscopy demonstrated 32% false negatives and 16% false positives for colitis diagnosis, emphasizing biopsy confirmation.
Impact:
- Colonoscopy is a safe and effective diagnostic tool for pediatric lower gastrointestinal diseases.
- Experienced endoscopists enhance procedure success rates, reaching the cecum and terminal ileum more frequently.
- Visual findings combined with biopsy confirmation improve the diagnostic accuracy for colitis in children.
Abstract:
Between 1978 and 1985 565 lower gastrointestinal endoscopies were performed in children. In 221 cases the cause of rectal bleeding was explored, in 227 the suspicion of colitis and in 25 of polyposis was verified. To evaluate the results of treatment (polypectomy, surgical procedures and medical therapy in inflammatory bowel disease) 121 examinations were done. With increasing experience the complete colonoscopy was performed more often. In 1985 coecum and ileum terminale was reached in almost all children in whom it was needed (75% of all examinations). The inflammatory changes were revealed on 230 occasions. In 78 cases colon polyps and in 27 vascular changes were found. The most common cause rectal bleeding were colon polyps (66 cases) and inflammatory changes (554 cases). Less common were vascular changes (10 cases). 32% false negative and 16% false positive results of colonoscopy in diagnosis colitis were obtained when the results of visual findings were compared with histopathological findings. Colonoscopy performed by an experienced colonoscopist rather avoiding general anesthesia is a safe and useful procedure in diagnosing lower gastrointestinal tract diseases in children. The evaluation of colitis should be based on visual findings with biopsy confirmation.