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Association of endoscopic findings and histological alterations in pediatric Crohn's disease
Julio César Moreno-Alfonso1, Sharom Barbosa-Velásquez2, Ada Molina Caballero3
1Cirugía Pediátrica, Hospital Universitario de Navarra, España.
Insights
In pediatric Crohn's disease (CD) patients, ulcers were the most common endoscopic finding. Endoscopic normality was more frequent in children without CD, highlighting key differences in gastrointestinal presentation.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Endoscopy
Background:
- Crohn's disease (CD) involves chronic gastrointestinal inflammation.
- Understanding endoscopic findings in pediatric CD is crucial for diagnosis.
- Clinicopathological correlations of endoscopic abnormalities in pediatric CD require further study.
Purpose of the Study:
- To analyze the association between endoscopic abnormalities and histopathological findings in pediatric patients.
- To compare endoscopic features in children with Crohn's disease (CD) versus those with normal histology (NCD).
- To determine the prevalence of endoscopic alterations in pediatric CD.
Main Methods:
- An analytical study included pediatric patients (<15 years) undergoing esophagoscopy/colonoscopy for suspected IBD (2015-2022).
- Patients were categorized into definite CD and normal histology (NCD) groups based on histopathology.
- Prevalence of endoscopic alterations and their association with histology were compared between groups.
Main Results:
- Of 502 endoscopies, 22 CD and 14 NCD patients were analyzed.
- Endoscopic normality was observed in 43% of NCD patients.
- Ulcers were the most prevalent macroscopic abnormality identified in pediatric CD patients.
Conclusions:
- Endoscopic findings differ significantly between pediatric Crohn's disease and normal histology.
- Ulcers represent a key endoscopic marker for Crohn's disease in children.
- Further research can refine diagnostic criteria using endoscopic and histopathological data.
Abstract:
Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) characterized by chronic, transmural, and relapsing inflammation that can affect any segment of the gastrointestinal tract, from the oral cavity to the anus. The clinicopathological association of various endoscopic abnormalities in CD is under study. An analytical study was conducted on patients under the age of 15 who underwent esophagoscopy and/or colonoscopy for suspected IBD at a pediatric hospital between 2015 and 2022 (Reg. No. 3318-0000206). Subjects with normal histopathological findings and those with a histological diagnosis of CD were included. The prevalence of different endoscopic alterations and their association with histopathological abnormalities were compared between patients with Crohn's disease (CD) and those with normal histology (NCD). Of the 502 endoscopies performed during this period, 22 subjects with CD and 14 children with NCD were included. Endoscopic normality, defined as the absence of mucosal abnormalities, was higher among NCD patients (43%), while the most prevalent macroscopic abnormality in CD patients was the presence of ulcers.
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