A prospective audit of paediatric colonoscopy under general anaesthesia

Pinfield, A.; Revell, L; McClean, Paddy; Puntis, J.W.L.

doi:10.1111/j.1651-2227.1999.tb01082.x

Cited by 35 publications

(9 citation statements)

References 12 publications

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“…In Asia, the prevalence rates of positive diagnostic findings were 45.8, 50.6, and 70.5% of studies from Korea, Hong Kong and South China, respectively [13–15]. In the United Kingdom, 62% of colonoscopies performed in children younger than 16 years old had abnormal findings [16]. Lissy et al reported that diagnostic colonoscopy revealed abnormalities in 80% of children referred with rectal bleeding [17].…”

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confidence: 99%

Current role of colonoscopy in infants and young children: a multicenter study

et al. 2019

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Background To evaluate the role of colonoscopy in infants and young children and clarify the distribution of colonoscopy-requiring diseases in this age group. Methods Cohorts of colonoscopies performed at three children’s hospitals in Japan between April 2011 and March 2016 including infants and children younger than six years of age were retrospectively reviewed. Results In total, 453 colonoscopies were performed in 276 infants and young children. Of these 275 (60.8%) were for diagnostic purposes, 177 (39.2%) were performed as follow-up, and one case was performed for treatment. The median patient age at the time of diagnostic colonoscopy was 2.49 years, and there was a male-to-female ratio of 1.72:1. Abnormal macroscopic and/or histopathological findings were noted in 212 (77.1%) cases. Of these, definite diagnoses were established for the presence of eosinophilic gastrointestinal disorders (EGIDs), inflammatory bowel disease (IBD), and polyp/polyposis in 23, 18.5, and 14% of patients, respectively. Among 51 IBD cases, ulcerative colitis, Crohn’s disease, and IBD-unclassified were identified in 47.1, 33.3, and 7.8%, retrospectively via endoscopic examination. Of these, 11 (22%) were eventually diagnosed with monogenic diseases via genetic testing. Of those with rectal bleeding, EGIDs, polyps/polyposis, and IBD were found in 27, 19, and 18%, retrospectively. There were significantly more cases of EGIDs and fewer ones of IBD and polyps/polyposis in patients with rectal bleeding younger than two years of age. Furthermore, 68% of all follow-up colonoscopies were performed in children with IBD. There were no serious complications in our study cohort. Conclusion We determined the role of colonoscopy in infants and young children. Diseases diagnosed using colonoscopy in this age group included IBD, EGIDs, and polyps/polyposis. The increasing trend of patients with IBD and EGIDs worldwide means that the role of colonoscopy in infants and younger children will be more important in the future.

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Section: Discussionmentioning

confidence: 99%

Current role of colonoscopy in infants and young children: a multicenter study

et al. 2019

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“…The findings were as follows: normal (41%), other (stricture/stenosis, tumor, anatomic deformity, Crohn disease, colitis, fissure/fistula/melanosis) (27%), mucosal abnormality (including pouchitis and proctitis) (21%), polyp (9%), and multiple polyps (2%). Others have reported similar normal rates of 38% to 45% (4)(5)(6). Pediatric colonoscopy is not without risk and complication rates have been up to 1.1% with perforation rates of 0.01% to 0.11% with no reported deaths (4,5,7,8).…”

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confidence: 91%

“…Others have reported similar normal rates of 38% to 45% (4)(5)(6). Pediatric colonoscopy is not without risk and complication rates have been up to 1.1% with perforation rates of 0.01% to 0.11% with no reported deaths (4,5,7,8).…”

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confidence: 91%

Are We Overdoing Pediatric Lower Gastrointestinal Endoscopy?

Kawada

O’Loughlin

Stormon

et al. 2017

J. pediatr. gastroenterol. nutr.

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Colonoscopy is a safe procedure in pediatrics; however, 39% of colonoscopies in this series were normal. Many of these could have been avoided by eliminating colonoscopy in patients with recurrent abdominal pain in the absence of other clinical features, conservative management with laxatives for those with fresh blood per rectum typical of anal fissures, and fecal calprotectin screening before endoscopy in patients with suspected IBD.

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“…These complications included one hemorrhage requiring transfusion and one perforation. In the second largest study, Stringer et al 2 prospectively described a series of 250 flexible colonoscopies done in the United Kingdom during a 3.5-year period with no adverse events. Several other studies reported complications (Table 1) in pediatric colonoscopy, but the majority of these studies examined a small number of procedures.…”

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Complications of Pediatric Colonoscopy: A Five-Year Multicenter Experience

Thakkar

El–Serag

Mattek

et al. 2008

Clinical Gastroenterology and Hepatology

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Colonoscopy has become a routine modality for the evaluation and treatment of colonic disorders in children. Although generally considered a safe procedure, colonoscopy has the potential for complications. Most informed consent forms describe adverse effects of sedative medicines, perforation, infection, and bleeding as possible risks of colonoscopy. However, the frequency of these complications remains unclear. There are limited pediatric data showing complication rates, and most prior studies involved small numbers of procedures. Furthermore, there might be additional complications that need to be added to consent protocols, because most current complication data are extrapolated from the much larger experience in adult populations.A review of pediatric literature demonstrated a wide array of potential complications and no large multicenter studies during the past 25 years. The largest study was conducted in [1978][1979] and included a survey of 1400 proctosigmoidoscopies performed during an 18-month period at 25 medical centers in the U.S. 1 This study was only published in abstract form and reported complications in 0.2% of all colonoscopy procedures. These complications included one hemorrhage requiring transfusion and one perforation. In the second largest study, Stringer et al 2 prospectively described a series of 250 flexible colonoscopies done in the United Kingdom during a 3.5-year period with no adverse events. Several other studies reported complications (Table 1) in pediatric colonoscopy, but the majority of these studies examined a small number of procedures.Determination of potential colonoscopy-related complications and their expected frequency in children can lead to enhanced risk-benefit analysis by physicians and patients and improved informed consent. There is a lack of systematic, multicenter studies in the pediatric population. Therefore, we conducted the current study to examine the frequency, type, and clinical determinants of immediate complications encountered during pediatric Address requests for reprints to: Kalpesh Thakkar, MD, 6621 Fannin St CCC 1010, Houston, TX 77030. kthakkar@bcm.tmc.edu; fax: 832-825-3633. Simple logistic regression was used to estimate the crude risk of cardiopulmonary events and gastrointestinal bleeding for variables that were identified as significantly associated with the outcomes during categorical analysis (P < .05). Multiple logistic regression models included all variables determined significant on univariate analysis. In constructing the models, we followed the commonly used heuristic of 10 outcome events for each explanatory variable. The adjusted risks estimate for each independent predictor variable was expressed as odds ratios. All analyses were performed by using SAS software (SAS Institute, Inc, Cary, NC). HHS Public Access ResultsDuring the study period, 8841 colonoscopies were recorded at 12 PEDS-CORI sites, and 1049 (11.9%) were excluded for incomplete procedure notes, duplicate records, or patient age older than 18 years. Thus, a total of 77...

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A prospective audit of paediatric colonoscopy under general anaesthesia

Cited by 35 publications

References 12 publications

Current role of colonoscopy in infants and young children: a multicenter study

Current role of colonoscopy in infants and young children: a multicenter study

Are We Overdoing Pediatric Lower Gastrointestinal Endoscopy?

Complications of Pediatric Colonoscopy: A Five-Year Multicenter Experience

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