Clin Endosc.  2020 Jul;53(4):436-442. 10.5946/ce.2019.118.

Endoscopic Yield, Appropriateness, and Complications of Pediatric Upper Gastrointestinal Endoscopy in an Adult Suite: A Retrospective Study of 822 Children

Affiliations
  • 1Department of Gastroenterology and Hepatology, Jawahar Lal Nehru Memorial Hospital (JLNMH), Srinagar, India
  • 2Department of Gastroenterology and Hepatology, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, India
  • 3Department of Community Medicine, Government Medical College (GMC) Srinagar, Srinagar, India

Abstract

Background/Aims
This study aimed to study the endoscopic yield, appropriateness, and complications of pediatric endoscopy performed by adult gastroenterologists in an adult endoscopic suite.
Methods
This a retrospective study in which records of all the patients less than 18 years of age who underwent endoscopy in the last 5 years were studied. The indications of endoscopy in children were categorized as appropriate or inappropriate per the latest guidelines by American Society for Gastrointestinal Endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Positive endoscopic yield was defined as the presence of any abnormality on endoscopy.
Results
Among the total of 822 children (age <18 years), the most common indications were variceal surveillance/eradication in 157 (19.1%), followed by dyspepsia in 143 (17.4%), upper gastrointestinal (UGI) bleeding in 136 (16.5%), recurrent abdominal pain in 94 (11.4%), unexplained anemia in 74 (9%), recurrent vomiting in 50 (6.08%), chronic refractory gastroesophageal reflux disease in 34 (4.1%) and others; 780 out of 822 endoscopic procedures (94.9%) done in children were appropriate as per the guidelines. The endoscopic yield was 45.8%, highest in patients with UGI bleeding (71.3%), followed by variceal surveillance (54.8%), recurrent vomiting (38%), dyspepsia (37.8%), and recurrent abdominal pain (36%). Minor adverse events occurred in 7.3% of children.
Conclusions
Pediatric endoscopy performed by an experienced adult gastroenterologist may be acceptable if done in cooperation with a pediatrician.

Keyword

Child; Complications; Endoscopy

Figure

  • Fig. 1. Graphical representation of endoscopic findings in different indications.


Cited by  1 articles

Safety and Competency are the Main Priorities in Pediatric Endoscopy
Byung-Ho Choe
Clin Endosc. 2020;53(4):379-380.    doi: 10.5946/ce.2020.124.


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