Korean J Gastroenterol.  2014 Dec;64(6):333-339. 10.4166/kjg.2014.64.6.333.

Current Status and Clinical Impact of Pediatric Endoscopy in Korea

• Lee YW
• Chung WC
• Sung HJ
• Kang YG
• Hong SL
• Cho KW
• Kang D
• Lee IH
• Jeon EJ

• KMID: 2160665
• DOI: http://doi.org/10.4166/kjg.2014.64.6.333

Abstract

BACKGROUND/AIMS
In pediatrics, endoscopic examination has become a common procedure for evaluation of gastrointestinal presentations. However, there are limited data on pediatric endoscopy in Korea. The aim of this study was to analyze the current status and clinical impacts of endoscopic examination in children and adolescents.
METHODS
We retrospectively reviewed the medical records of outpatients who visited the tertiary hospital. Patients under 18 years of age who underwent endoscopy were included. Endoscopic findings were classified as specific and normal based on gross findings. Specific endoscopic findings were reflux esophagitis, peptic ulcers, and Mallory-Weiss tear. Other findings included acute gastritis classified according to the updated Sydney system.
RESULTS
In 722 of 330,350 patients (0.2%), endoscopic examination (554 esophagogastroduodenoscopies [EGDs], 121 colonoscopies, 47 sigmoidoscopies) was performed between January 2008 and January 2013. In EGD, abdominal pain was the most frequent presentation (64.1%). The most common diagnosis was gastritis (53.2%), followed by reflux esophagitis. The frequency of peptic ulcer disease was 12.8%. Frequent symptoms leading to colonoscopic examination were abdominal pain, diarrhea, and hematochezia. In colonoscopy, a negative result was more likely in children younger than 7 years old. After the procedure, the diagnostic yield of EGD and colonoscopy was 88.1% and 45.8%, respectively, and the rate of change in management was 67.1%.
CONCLUSIONS
In pediatrics, endoscopic examination was useful for the choice of therapeutic strategy and it would be a standard method for evaluation of gastrointestinal presentation.

Keyword

Endoscopy; Pediatrics; Abdominal pain

MeSH Terms

Abdominal Pain
Adolescent
Child
Child, Preschool
*Endoscopy, Digestive System
Esophagitis, Peptic/diagnosis/drug therapy
Female
Gastritis/diagnosis/drug therapy
Gastrointestinal Hemorrhage/diagnosis
Histamine H2 Antagonists/therapeutic use
Humans
Infant
Infant, Newborn
Inflammatory Bowel Diseases/diagnosis
Male
Peptic Ulcer/diagnosis/drug therapy
Proton Pump Inhibitors/therapeutic use
Republic of Korea
Retrospective Studies
Tertiary Care Centers
Histamine H2 Antagonists
Proton Pump Inhibitors

Figure

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  Fig. 1. Gastritis was the most common diagnosis of pediatric esophagogastroduodenoscopy; erythematous and edematous mucosal change in the whole stomach.

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  Fig. 2. Various findings during pediatric colonoscopy; (A) Crohn's disease, (B) intestinal tuberculosis, (C) lymphoma, (D) rectal ulcer.

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