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[Pediatric colonoscopy]
A Poerregaard1, A V Wewer, P U Becker
1H:S Hvidovre Hospital, børneafdelingen og medicinsk gastroenterologisk afdeling.
Insights
Pediatric colonoscopy is a safe and effective procedure for diagnosing inflammatory bowel disease and other intestinal conditions in children. This study highlights its diagnostic value and low complication rate in young patients.
Area of Science:
- Pediatric Gastroenterology
- Endoscopy
- Diagnostic Procedures
Background:
- Chronic inflammatory bowel disease and rectal bleeding are common indications for pediatric colonoscopy.
- Accurate diagnosis in pediatric patients is crucial for effective management.
Purpose of the Study:
- To describe the procedure and outcomes of colonoscopies in children.
- To evaluate the safety and diagnostic yield of colonoscopy in pediatric patients.
Main Methods:
- Fifty colonoscopies were performed on 43 children (0.3-16 years) over three years.
- General anesthesia was used for younger children (<10 years), while sedation was used for older children (≥10 years).
- Bowel preparation was conducted prior to the procedure.
Main Results:
- Colonoscopy successfully visualized the cecum in 96% and intubated the terminal ileum in 77% of cases.
- Diagnosed inflammatory bowel disease in 21 of 30 suspected cases and removed polyps in two cases.
- Endoscopic findings often predicted histological diagnosis but tended to underestimate disease severity compared to microscopy.
Conclusions:
- Colonoscopy is a safe and informative procedure for evaluating the large bowel and terminal ileum in children.
- The study demonstrates the diagnostic utility of colonoscopy in pediatric gastrointestinal evaluations.
- No complications were reported, underscoring the procedure's safety profile in this age group.
Abstract:
The procedure and results of 50 colonoscopies performed over a three-year period on a group of 43 children (range: 0.3-16 yr; median: 9 yr) are described. The main indications were evaluation for, or control of already known, chronic inflammatory bowel disease (n = 38) and rectal bleeding (n = 8). Following verbal and written information the children were admitted one to two days before the procedure for bowel preparation. Children < 10 years old received general anaesthesia during the colonoscopy (n = 25) and most children > or = 10 years old received an intravenous sedation with pethidine and midazolam (n = 25). In only one case was intravenous sedation not successful. The coecum was visualised in 96% and the terminal ileum intubated in 77% (when intended) of the endoscopies. The most important results obtained were establishment of the diagnosis of inflammatory bowel disease in 21 of 30 suspected cases and the removal of a polyp in two cases. At the time of colonoscopy a "best guess" diagnosis of either ulcerative colitis or Crohn's disease often predicted the histological diagnosis, but endoscopy tended to underestimate the severity and extent of the inflammation as compared to microscopy. There were no complications. We conclude that colonoscopy performed according to our recommendations is a safe and informative procedure for evaluation of the large bowel and terminal ileum in children with intestinal disease.