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Utility of Diagnostic Colonoscopy in Pediatric Intestinal Disease
Masaru Morita1, Hidetoshi Takedatsu1, Shinichiro Yoshioka1
1Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi Kurume, Fukuoka 830-0011, Japan.
Insights
Pediatric diagnostic colonoscopy methods evolved, showing increased inflammatory bowel disease and eosinophilic gastrointestinal disorder diagnoses. This highlights the importance of colonoscopy in children for accurate gastrointestinal condition diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Endoscopy
- Colorectal Medicine
Background:
- Previous studies established diagnostic colonoscopy roles in pediatric patients.
- Advances in medical technology and increased demand necessitate updated pediatric endoscopic diagnostic approaches.
- This study compares recent pediatric colonoscopy data with historical findings.
Purpose of the Study:
- To compare recent diagnostic colonoscopy outcomes in pediatric patients with previously reported data.
- To identify changes in indications, diagnoses, and methods used in pediatric colonoscopy over time.
Main Methods:
- Retrospective analysis of pediatric patients (≤15 years) undergoing first diagnostic colonoscopy.
- Comparison of two cohorts: January 2007-February 2015 and March 2015-February 2022.
- Data collected from Kurume University Hospital.
Main Results:
- 274 patients included (110 previous, 164 current study).
- Abdominal pain became the primary indication; ulcerative colitis remained the most common diagnosis.
- Increased diagnoses of Crohn's disease and eosinophilic gastrointestinal disorders noted.
- Magnesium citrate bowel preparation and midazolam + pentazocine sedation were frequently used.
- Age-specific ultrathin endoscope and colonoscope utilization was documented.
Conclusions:
- Diagnostic colonoscopy methods and roles in pediatric patients have evolved.
- The rising incidence of pediatric inflammatory bowel disease and eosinophilic gastrointestinal disorders underscores the critical role of colonoscopy in this age group.
Background:
The roles and methods of diagnostic colonoscopy in pediatric patients were previously demonstrated. With advances in medical equipment and the increasing need for pediatric endoscopic diagnosis, we compared recent results with those previously reported.
Methods:
A retrospective analysis was conducted on pediatric patients aged ≤15 years, comparing those who underwent their first diagnostic colonoscopy between 1 January 2007 and 28 February 2015 with those who did so between 1 March 2015 and 28 February 2022 at Kurume University Hospital.
Results:
A total of 274 patients were included, including 110 in the previous study and 164 in the present study. The main indications were hematochezia in the previous study (63/110, 57.3%) and abdominal pain in the present study (64/164, 39.0%). Ulcerative colitis (74/274, 27.0%) was the most common diagnosis in both studies. The major difference from the previous study was an increase in the number of Crohn's disease and eosinophilic gastrointestinal disorder cases. Bowel preparation with magnesium citrate was significantly increased across all ages in the present study (142/164, 86.6%). Midazolam + pentazocine was used for sedation in most cases (137/164, 83.5%). An ultrathin upper endoscope was mainly used in patients aged ≤6 years, while ultrathin colonoscopes were applied in patients aged 7-12 years.
Conclusion:
In the present study, appropriate changes were found in the roles and methods of diagnostic colonoscopy in pediatric patients compared to the previous study. The increasing trend of patients presenting with inflammatory bowel disease and eosinophilic gastrointestinal disorder worldwide indicates the importance of colonoscopy in infants and children.
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