Diagnostic Role of Upper Gastrointestinal Endoscopy in Pediatric Inflammatory Bowel Disease

Castellaneta, Stefania; Afzal, Nadeem; Greenberg, Meidad; Deere, Harriet; Davies, Sophia Elizabeth Campbell; Murch, SH; Walker-Smith, J A; Thomson, Mike

doi:10.1097/00005176-200409000-00006

Cited by 148 publications

(63 citation statements)

References 20 publications

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“…(11) The high frequency of occurrence of upper gastrointestinal inflammation in our series is also consistent with that of previous reports (range 50%-64%). (34,35) These findings emphasise the importance of routine upper endoscopy in all children suspected of having IBD regardless of any upper gastrointestinal symptoms, as findings of aphthous ulcers or granulomas may help to confirm a diagnosis of CD, which might otherwise be missed. The high incidence of H. pylori colonisation in our patients was likely related to its high prevalence in the local population.…”

Section: Discussionmentioning

confidence: 89%

Paediatric inflammatory bowel disease in a multiracial Asian country

Chu

Logarajah²,

Tan³

et al. 2013

SMedJ

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Information on demographics, disease presentation, laboratory findings, radiological investigations, and endoscopic and histological findings were obtained from the patients' medical records.RESUlTS 32 patients were diagnosed with IBD, 30 of whom had Crohn's disease and 2 had ulcerative colitis. The incidence of IBD rose from an initial rate of 2.2 per 100,000 patients in the year 2000 to a peak of 11.4 patients per 100,000 patients by 2008. Median age of onset of symptoms was 10.5 years. There were more boys (63%) than girls in the group and a higher representation of Indians (34.4%). The most common presenting symptoms were abdominal pain (87.5%), diarrhoea (75.0%) and weight loss (71.9%). Extraintestinal manifestations such as fever and arthralgia were found in over 50% of patients. The most common physical findings were perianal abnormalities (56.3%), mouth ulcers (37.5%) and growth failure (15.6%). Abnormal laboratory findings such as low albumin, raised erythrocyte sedimentation rate, anaemia, thrombocytosis and high C-reactive protein were found in nearly half of the patients. Endoscopic and histological findings showed that a majority of patients (90.6%) also had evidence of inflammation in the upper gastrointestinal tract.CONClUSION Paediatric IBD is on the rise. The higher occurrence in Indians, earlier onset and more florid presentation may suggest different genetic and environmental influences specific to Asian children.

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Section: Discussionmentioning

confidence: 89%

Paediatric inflammatory bowel disease in a multiracial Asian country

Chu

Logarajah²,

Tan³

et al. 2013

SMedJ

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“…Among children with recurrent abdominal pain, the yield of upper GI endoscopy is low [20], whereas among patients with proximal GI mucosal disease [21], there appears to be a higher yield. Our overall diagnostic yield of 70% exceeds reports of endoscopic yield in patients with Crohn's disease [21] and other conditions.…”

Section: Discussionmentioning

confidence: 99%

High diagnostic yield of gastrointestinal endoscopy in children with intestinal failure

Ching

Modi

Jaksic

et al. 2008

Journal of Pediatric Surgery

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Purpose-Children with intestinal failure (IF) often have gastrointestinal (GI) symptoms, including bleeding, increased stool output, and feeding intolerance. The use of endoscopic assessment of these symptoms has not been previously reported. This report evaluates the diagnostic yield of GI endoscopy in the setting of IF.Methods-After institutional review board approval, we reviewed the medical records (including endoscopy, pathology and microbiology data) of patients with IF who underwent GI endoscopies between September 1999 and March 2007.Results-Twenty-seven patients underwent 61 GI endoscopies: 34 esophagogastroduodenoscopies, 17 colonoscopies, 7 flexible sigmoidoscopies, and 3 ileoscopies. Indications for endoscopy, which were not mutually exclusive, included chronic diarrhea (39%, n = 24), GI bleeding (36%, n = 22), suspected bacterial overgrowth (36%, n = 22), and suspected peptic disease (15%, n = 9). Based on gross endoscopic appearance, histopathology, or microbiology, 43 (70%) procedures yielded abnormalities. These included infectious (20%, n = 12), anatomical (18%, n = 11), peptic (15%, n = 9), allergic (15%, n = 9), and other (2%, n = 1) findings. Eleven (73%) of 15 duodenal cultures grew a spectrum of 17 bacterial species. Overall, 24 (89%) of 27 patients had gross endoscopic, histopathologic, or microbiologic abnormalities. Conclusions-In

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“…The findings on upper endoscopy, although often non-specific, may provide additional information in a patient with indeterminate disease of the colon especially if granulomas are found. A recent study found upper gastrointestinal inflammation in 29 of 54 children (22 CD; 7 UC) [14] . Epigastric and abdominal pain, nausea and vomiting, weight loss and pan-ileocolitis were predictive of upper gastrointestinal involvement.…”

Section: Diagnosismentioning

confidence: 96%

Special issues in pediatric inflammatory bowel disease

Dubinsky¹

2007

WJG

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The incidence of pediatric inflammatory bowel disease (IBD) is rising and recent advances in diagnostics and therapeutics have improved the care provided to these children. There are distinguishing features worth noting between early onset and adult onset IBD. Physical and psychosocial development remains a critical target for the comprehensive management of pediatric IBD. Children are not just little adults and consideration must be given to the stages of development and how these stages impact disease presentation and management. The final stage will be the transition from pediatric care to that of adult oriented care and special consideration must be given to make this a successful process. This review highlights special considerations in the management of the child with IBD.

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Diagnostic Role of Upper Gastrointestinal Endoscopy in Pediatric Inflammatory Bowel Disease

Abstract: Upper gastrointestinal tract endoscopy should be part of the first-line investigation in all new cases suspected of IBD. Absence of specific upper gastrointestinal symptoms do not preclude presence of upper gastrointestinal inflammation.

Cited by 148 publications

References 20 publications

Paediatric inflammatory bowel disease in a multiracial Asian country

Paediatric inflammatory bowel disease in a multiracial Asian country

High diagnostic yield of gastrointestinal endoscopy in children with intestinal failure

Special issues in pediatric inflammatory bowel disease

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