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Upper gastrointestinal endoscopy in infants and children
Insights
Pediatric upper gastrointestinal endoscopy is effective for diagnosis and treatment. Key considerations include anesthesia, with variceal bleeding being the most common issue, successfully managed by injection sclerotherapy.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
Background:
- Fibreoptic endoscopy is increasingly utilized in pediatric patients.
- Special considerations for pediatric endoscopy include specialized instruments, anesthesia, and specific indications.
Purpose of the Study:
- To evaluate the efficacy and safety of upper gastrointestinal endoscopy in children.
- To identify common causes of upper gastrointestinal bleeding and outcomes of therapeutic interventions in pediatric patients.
Main Methods:
- A retrospective review of 132 children undergoing upper gastrointestinal endoscopy over 24 months.
- Procedures included diagnostic and therapeutic endoscopy, with varying anesthesia protocols based on age.
Main Results:
- 132 children underwent 102 diagnostic and 162 therapeutic endoscopic procedures.
- Variceal bleeding (60.6%) was the most frequent cause of upper GI bleeding, followed by erosive gastritis (27.2%).
- Injection sclerotherapy effectively controlled variceal bleeding, and endoscopic retrieval was successful for most ingested foreign bodies.
Conclusions:
- Pediatric upper gastrointestinal endoscopy is a valuable tool for diagnosis and therapy.
- Anesthesia management varies by age, and endoscopic interventions are effective for common pediatric GI conditions like variceal bleeding and foreign body ingestion.
Abstract:
Fibreoptic endoscopy is a highly efficient diagnostic tool which is now being increasingly used in pediatric age group also. However, certain special considerations like the use of special instruments, use of general anesthesia in younger children and various indications of diagnostic and therapeutic endoscopy need to be clearly emphasized. Over a period of 24 months, 132 children underwent upper gastrointestinal endoscopic examination in our section. Diagnostic endoscopy was carried out on 102 occasions and therapeutic on 162 occasions. Most of the children below 3 years of age required general anesthesia for the procedure. Children above 3 years of age could be managed by intravenous diazepam and pentazocine. The commonest cause of upper gastrointestinal bleed in children was variceal (60.6%) followed by erosive gastritis (27.2%). In children with recurrent abdominal pain no underlying cause was detected at endoscopy. Injection sclerotherapy was found to be a safe and effective mean for control of variceal bleed and most of the foreign bodies ingested by children and still lying proximal to 2nd part of duodenum could be successfully retrieved endoscopically.