EUS and EUS-Guided Interventions Alter Clinical Management in Children With Digestive Diseases

Area of Science:

• Pediatric Gastroenterology
• Gastrointestinal Endoscopy
• Diagnostic Imaging

Background:

• Endoscopic ultrasound (EUS) ± fine needle aspiration (FNA) is established for adult gastrointestinal disorders.
• Its utility in pediatric patients remains less defined and is evolving.

Purpose of the Study:

• To evaluate the clinical utility and impact on management of EUS and EUS-guided interventions in pediatric patients.
• To assess the diagnostic yield and therapeutic effectiveness of EUS in children with pancreaticobiliary conditions.

Main Methods:

• Retrospective, single-center study of 43 pediatric patients (4-18 years) undergoing 51 EUS procedures.
• Data collected on indications, findings, interventions (EUS-FNA), and subsequent clinical management changes.

Main Results:

• Common indications included suspected biliary obstruction, pancreatic cysts, and pancreatitis.
• EUS identified various findings, including cysts, pseudocysts, sludge, stones, and pancreatitis.
• EUS-FNA successfully treated pancreatic pseudocysts; EUS altered management in 47% of procedures, leading to new diagnoses in 79% of patients.

Conclusions:

• EUS and EUS-guided interventions are effective diagnostic and management tools in pediatric patients.
• EUS should be considered for children with challenging pancreaticobiliary disorders.