Use of single-use ultra-slim endoscopes for evaluation of pediatric esophageal varices: A pilot feasibility study

Esophageal varices (EV) need monitoring in patients with portal hypertension. In 2022, a single-use ultra-slim (3.5 mm) gastroscope was approved for use in children and adults. This study evaluated if an ultra-slim gastroscope could evaluate, grade, and corroborate the presence of EV in sedated pediatric patients as compared to standard oral gastroscopes (>8.6 mm). Ten pediatric subjects with suspected or known EV underwent surveillance endoscopy using the ultra-slim endoscope followed by the standard gastroscope under sedation. Esophageal findings were analyzed using images from both procedures by two independent endoscopists. Visual findings for the presence or absence of EV had 100% congruence. EV were identified in 8/10 subjects (Grade I (4), Grade II (3), and Grade II/III (1)). Endoscopic grading matched between both endoscopes in 7/8 (87.5%) cases. Ultra-slim and standard gastroscopes showed reliable visual agreement and could be used similarly in certain clinical settings to evaluate EV.