Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
권호 표지
DOI QR코드

DOI QR Code

Role of colonoscopy in the diagnosis and treatment of pediatric lower gastrointestinal disorders

  • Park, Jae-Hong (Department of Pediatrics, School of Medicine, Pusan National University)
  • Received : 2010.08.02
  • Accepted : 2010.08.23
  • Published : 2010.09.15
Download PDF
⟨ Previous Next ⟩

Abstract

The safety and effectiveness of colonoscopy in the investigation of lower gastrointestinal tract pathology in children has been established for more than 2 decades in Korea. The skill and experience have since advanced to the point that both diagnostic and therapeutic colonoscopy are now routinely performed by most pediatric gastroenterologists. Pediatric colonoscopy differs significantly from its adult parallels in nearly every aspect including patient and parent management and preparation, selection criteria for sedation and general anesthetic, bowel preparation, expected diagnoses, instrument selection, imperative for terminal ileal intubation, and requirement for biopsies from macroscopically normal mucosa. Investigation of inflammatory bowel disease, whether for diagnosis or follow-up evaluation, and suspected colonic polyps are the most common indication for pediatric colonoscopy. The child who presents with signs and symptoms of lower gastrointestinal disorder should undergo colonoscopy with biopsy to make the diagnosis, as well as to help determine the appropriate therapy. This review introduces practical information on pediatric colonoscopy, the author's experiences, and the role of colonoscopic examination in the diagnosis and treatment of pediatric lower gastrointestinal disorders.

Keywords

References

  1. Victor LF. Colonoscopy. In: Walker WA, Durie PR, Hamilton JR, Walker-Smith JA, Watkins JB, editors. Pediatric gastrointestinal disease. Pathophysiology, diagnosis, management. 2nd ed. St. Louis: Mosby, 1996:1533-41.
  2. Park EB. Pediatric colonoscopy. Korean J Gastrointest Endosc 1984;4:28-34.
  3. Seo JK. Pediatric endoscopy. Proceedings of the 3rd Gastrointestinal Endoscopy Seminar; 1990; 29-35; The Korean Society of Gastrointestinal Endoscopy.
  4. Seo JK. Pediatric endoscopy for the diagnosis and management of gastrointestinal diseases in children. J Korean Pediatr Soc 1996;39:461-74.
  5. Thomson M. Colonoscopy and enteroscopy. Gastrointest Endosc Clin N Am 2001;11:603-39.
  6. Israel DM, McLain BI, Hassall E. Successful pancolonoscopy and ileoscopy in children. J Pediatr Gastroenterol Nutr 1994;19:283-9. https://doi.org/10.1097/00005176-199410000-00004
  7. Stringer MD, Pinfield A, Revell L, McClean P, Puntis JW. A prospective audit of paediatric colonoscopy under general anaesthesia. Acta Paediatr 1999;88:199-202.
  8. de Ridder L, van Lingen AV, Taminiau JA, Benninga MA. Rectal bleeding in children: endoscopic evaluation revisited. Eur J Gastroenterol Hepatol 2007;19:317-20. https://doi.org/10.1097/MEG.0b013e328080caa6
  9. Park KH, Park JH. Changes in pediatric gastrointestinal endoscopy: review of a recent hospital experience. Korean J Pediatr Gastroenterol Nutr 2007;10:20-7.
  10. Kay M, Wyllie R. Esophagogastroduodenoscopy, colonoscopy and related techniques. In: Wyllie R, Hyams JS, editors. Pediatric gastrointestinal and liver disease. pathophysiology, diagnosis, management. 3rd ed. Philadelphia: Saunders Elsevier, 2006:1251-89.
  11. Dahshan A, Lin CH, Peters J, Thomas R, Tolia V. A randomized, prospective study to evaluate the efficacy and acceptance of three bowel preparations for colonoscopy in children. Am J Gastroenterol 1999;94:3497-501. https://doi.org/10.1111/j.1572-0241.1999.01613.x
  12. Balsells F, Wyllie R, Kay M, Steffen R. Use of conscious sedation for lower and upper gastrointestinal endoscopic examinations in children, adolescents, and young adults: a twelve-year review. Gastrointest Endosc 1997;45:375-80. https://doi.org/10.1016/S0016-5107(97)70147-0
  13. American Academy of Pediatrics, Committee on Drugs, Section on Anethesiology. Guidelines for the elective use of conscious sedation, deep sedation, and general anesthesia in pediatric patients. Committee on Drugs. Section on anesthesiology. Pediatrics 1985;76:317-21.
  14. Batres LA, Maller ES, Ruchelli E, Mahboubi S, Baldassano RN. Terminal ileum intubation in pediatric colonoscopy and diagnostic value of conventional small bowel contrast radiography in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2002;35:320-3. https://doi.org/10.1097/00005176-200209000-00015
  15. Lee NY, Park JH. Clinical features and course of Crohn disease in children. Korean J Gastrointest Endosc 2007;34:193-9.
  16. Chuang E, Zimmerman A, Neiswender KM, Liacouras CA. Sedation in pediatric endoscopy. Gastrointest Endosc Clin N Am 2001;11:569-84.
  17. Hirota WK, Petersen K, Baron TH, Goldstein JL, Jacobson BC, Leighton JA, et al.; Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy. Guidelines for antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc 2003;58:475-82. https://doi.org/10.1067/S0016-5107(03)01883-2
  18. Low DE, Shoenut JP, Kennedy JK, Sharma GP, Harding GK, Den Boer B, et al. Prospective assessment of risk of bacteremia with colonoscopy and polypectomy. Dig Dis Sci 1987;32:1239-43. https://doi.org/10.1007/BF01296372
  19. Neu HC, Fleischer D. Controversies, dilemmas, and dialogues. Recommendations for antibiotic prophylaxis before endoscopy. Am J Gastroenterol 1989;84:1488-91.
  20. Sieg A, Hachmoeller-Eisenbach U, Eisenbach T. Prospective evaluation of complications in outpatient GI endoscopy: a survey among German gastroenterologists. Gastrointest Endosc 2001;53:620-7. https://doi.org/10.1067/mge.2001.114422
  21. Nelson DB, McQuaid KR, Bond JH, Lieberman DA, Weiss DG, Johnston TK. Procedural success and complications of large-scale screening colonoscopy. Gastrointest Endosc 2002;55:307-14. https://doi.org/10.1067/mge.2002.121883
  22. Korman LY, Overholt BF, Box T, Winker CK. Perforation during colonoscopy in endoscopic ambulatory surgical centers. Gastrointest Endosc 2003;58:554-7. https://doi.org/10.1067/S0016-5107(03)01890-X
  23. Park JH. Characteristics of angiodysplasia in children and effect of argon plasma coagulation on treatment of angiodysplasia. Korean J Gastrointest Endosc 2002;25:335.
  24. Mendeloff A, Calkins B. The epidemiology of idiopathic inflammatory bowel disease. In: Kirsner J, Shorter R, editors. Inflammatory bowel disease. Philadelphia: Lea & Febiger, 1998:3-34.
  25. Baldassano RN, Piccoli DA. Inflammatory bowel disease in pediatric and adolescent patients. Gastroenterol Clin North Am 1999;28:445-58. https://doi.org/10.1016/S0889-8553(05)70064-9
  26. Sentongo TA, Semeao EJ, Piccoli DA, Stallings VA, Zemel BS. Growth, body composition, and nutritional status in children and adolescents with Crohn's disease. J Pediatr Gastroenterol Nutr 2000;31:33-40. https://doi.org/10.1097/00005176-200007000-00009
  27. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition; Colitis Foundation of America, Bousvaros A, Antonioli DA, Colletti RB, Dubinsky MC, Glickman JN, et al. Differentiating ulcerative colitis from Crohn disease in children and young adults: report of a working group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Crohn's and Colitis Foundation of America. J Pediatr Gastroenterol Nutr 2007;44:653-74. https://doi.org/10.1097/MPG.0b013e31805563f3
  28. Fefferman DS, Farrell RJ. Endoscopy in inflammatory bowel disease: indications, surveillance, and use in clinical practice. Clin Gastroenterol Hepatol 2005;3:11-24. https://doi.org/10.1016/S1542-3565(04)00441-0
  29. Halligan S, Saunders B, Williams C, Bartram C. Adult Crohn disease: can ileoscopy replace small bowel radiology? Abdom Imaging 1998;23:117-21. https://doi.org/10.1007/s002619900301
  30. Richter JM, Christensen MR, Kaplan LM, Nishioka NS. Effectiveness of current technology in the diagnosis and management of lower gastrointestinal hemorrhage. Gastrointest Endosc 1995;41:93-8. https://doi.org/10.1016/S0016-5107(05)80588-7
  31. Buchman TG, Bulkley GB. Current management of patients with lower gastrointestinal bleeding. Surg Clin North Am 1987;67:651-64. https://doi.org/10.1016/S0039-6109(16)44237-4
  32. Gelb AM, Minkowitz S, Tresser M. Rectal and colonic polyps occurring in young people. N Y State J Med 1962;62:513-8.
  33. Jalihal A, Misra SP, Arvind AS, Kamath PS. Colonoscopic polypectomy in children. J Pediatr Surg 1992;27:1220-2. https://doi.org/10.1016/0022-3468(92)90792-6
  34. Poddar U, Thapa BR, Vaiphei K, Singh K. Colonic polyps: experience of 236 Indian children. Am J Gastroenterol 1998;93:619-22. https://doi.org/10.1111/j.1572-0241.1998.176_b.x
  35. Mestre JR. The changing pattern of juvenile polyps. Am J Gastroenterol 1986;81:312-4.
  36. Gans SL, Ament M, Christie DL, Liebman WM. Pediatric endoscopy with flexible fiberscopes. J Pediatr Surg 1975;10:375-80. https://doi.org/10.1016/0022-3468(75)90102-5
  37. Holgersen LO, Mossberg SM, Miller RE. Colonoscopy for rectal bleeding in childhood. J Pediatr Surg 1978;13:83-5. https://doi.org/10.1016/S0022-3468(78)80217-6
  38. Hemingway AP. Angiodysplasia as a cause of iron deficiency anaemia. Blood Rev 1989;3:147-51. https://doi.org/10.1016/0268-960X(89)90011-8
  39. de la Torre Mondragon L, Vargas Gomez MA, Mora Tiscarreno MA, Ramirez Mayans J. Angiodysplasia of the colon in children. J Pediatr Surg 1995;30:72-5. https://doi.org/10.1016/0022-3468(95)90614-2
  40. Khan K, Schwarzenberg SJ, Sharp H, Weisdorf-Schindele S. Argon plasma coagulation: Clinical experience in pediatric patients. Gastrointest Endosc 2003;57:110-2.

Cited by

  1. Diagnostic Yield of Pediatric Colonoscopies Based on Presenting Symptoms in a Secondary Hospital vol.14, pp.4, 2011, https://doi.org/10.5223/kjpgn.2011.14.4.368
  2. 소아 선혈변에서 대장 내시경 검사의 역할 vol.14, pp.2, 2010, https://doi.org/10.5223/kjpgn.2011.14.2.155
  3. Juvenile Polyp and Colonoscopic Polypectomy in Childhood vol.15, pp.4, 2010, https://doi.org/10.5223/pghn.2012.15.4.250
  4. An update on pediatric endoscopy vol.18, pp.18, 2010, https://doi.org/10.1186/2047-783x-18-24
  5. A Case of a Child with an APC Pathogenic Mutation, Aberrant Expression of Splice Variants and Positive Family History of FAP vol.44, pp.6, 2010, https://doi.org/10.1093/jjco/hyu050
  6. Pediatric Colonoscopy in South China: A 12-Year Experience in a Tertiary Center vol.9, pp.4, 2014, https://doi.org/10.1371/journal.pone.0095933
  7. Gastrointestinal hemangioma in childhood: a rare cause of gastrointestinal bleeding vol.57, pp.5, 2014, https://doi.org/10.3345/kjp.2014.57.5.245
  8. Quality of colonoscopy in children with rectal bleeding in Egypt vol.27, pp.None, 2010, https://doi.org/10.4103/1110-7782.155841
  9. Indications for gastrointestinal endoscopy in childhood vol.101, pp.12, 2010, https://doi.org/10.1136/archdischild-2014-306043
  10. Unusual presentation of jejunal hemangioma on Tc-99m pertechnetate scan with single-photon emission computerized tomography-computed tomography vol.18, pp.3, 2010, https://doi.org/10.4103/wjnm.wjnm_13_19
  11. Diagnostic performance of ultrasound without any colon preparation for detecting colorectal polyps in pediatric patients vol.49, pp.10, 2010, https://doi.org/10.1007/s00247-019-04467-5
  12. The Efficacy of Cap-Assisted Colonoscopy as Compared to Conventional in a Pediatric Population: A Randomized Controlled Trial vol.103, pp.5, 2010, https://doi.org/10.35755//jmedassocthai.2020.05.10713
  13. Juvenile Polyps in Bangladeshi Children and Their Association with Fecal Calprotectin as a Biomarker vol.25, pp.1, 2022, https://doi.org/10.5223/pghn.2022.25.1.52