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Study to determine guidelines for pediatric colonoscopy
Shinichiro Yoshioka1, Hidetoshi Takedatsu2, Shuhei Fukunaga1
1Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Asahi-machi Kurume, Fukuoka 830-0011, Japan.
Insights
Total colonoscopy in pediatric patients diagnosed inflammatory bowel disease in 70.9% of cases. Appropriate bowel preparation, sedation, and endoscope selection are crucial for successful pediatric colonoscopy.
Area of Science:
- Gastroenterology
- Pediatric Endoscopy
Background:
- Colonoscopy is a valuable diagnostic tool for pediatric gastrointestinal disorders.
- Understanding the specific characteristics and management of pediatric colonoscopy is essential.
Purpose of the Study:
- To investigate the characteristics, diagnosis, bowel-cleansing preparation, sedation, and colonoscope selection in Japanese pediatric patients undergoing total colonoscopy.
- To assess the diagnostic yield of colonoscopy in this population.
Main Methods:
- Retrospective analysis of 110 pediatric patients (≤ 15 years) who underwent their first total colonoscopy between January 2007 and February 2015.
- Data collected included patient demographics, symptoms, bowel preparation, sedation methods, endoscope specifications, and diagnostic outcomes.
Main Results:
- Hematochezia, abdominal pain, and diarrhea were the most frequent symptoms.
- Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, was the most common diagnosis (70.9%).
- Age-specific protocols for bowel preparation and sedation were employed, with younger children receiving different agents and smaller endoscopes.
Conclusions:
- Colonoscopy demonstrates high diagnostic capability in pediatric patients presenting with gastrointestinal symptoms.
- Tailoring bowel preparation, sedation, and endoscopic equipment to pediatric patients is vital for effective colonoscopy performance and diagnosis.
Aim:
To investigated characteristics, diagnosis, bowel-cleansing preparation, sedation, and colonoscope length and diameter in Japanese pediatric patients receiving total colonoscopy.
Methods:
The present study evaluated consecutive patients aged ≤ 15 years who had undergone their first colonoscopy in Kurume University between January 2007 and February 2015. Data were retrospectively analyzed. We identified 110 pediatric patients who had undergone colonoscopy that had reached the cecum, allowing the observation of the total colon.
Results:
Hematochezia, abdominal pain, and diarrhea were the most common symptoms. For bowel-cleansing preparation, pediatric patients aged ≤ 12 years were treated with magnesium citrate, and patients aged 13-15 years were treated with polyethylene glycol 4000. For sedation, thiamylal with pentazocine, which has an analgesic effect, was used in patients aged ≤ 6 years, and midazolam with pentazocine was used in patients aged ≥ 7 years. Regarding the choice of endoscope, short and thin endoscopes were selected for younger patients, particularly patients aged ≤ 3 years. Positive diagnoses were made in 78 patients (70.9%). Inflammatory bowel disease (n = 49, 44.5%), including ulcerative colitis (n = 37, 33.6%) and Crohn's disease (n = 12, 10.9%), was the most common diagnosis.
Conclusion:
Colonoscopy offers a high diagnostic capability for pediatric patients with gastrointestinal symptoms. The selection of appropriate management the performance of colonoscopy is important in pediatric patients.
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