Endoscopic Modalities in Pediatric Inflammatory Bowel Disease

Endoscopy in Paediatric Inflammatory Bowel Disease (IBD)

“…The presence of symptoms related to the upper gastrointestinal tract such as disphagia, odinophagia, nausea and/or vomit, oral ulcers, represents a typical indication to an uppertract endoscopy in the phases of diagnosis and staging of IBD [4][5]. It should also be noted that even in the absence of symptoms, the upper gastrointestinal tract involvement appears more and more frequently present at the endoscopic and histological evaluation of patients with CD.…”

“…It should also be noted that even in the absence of symptoms, the upper gastrointestinal tract involvement appears more and more frequently present at the endoscopic and histological evaluation of patients with CD. The importance of taking biopsies at this level has to be considered, even with an endoscopically normal mucosa [4][5]. 'Small-bowel endoscopy' is defined as any endoluminal examination of the small bowel, including capsule endoscopy, push enteroscopy and balloon-or other device-assisted endoscopy [2].…”

“…The endoscopic lesions that are typically observed in oesophagus include erythema, ulcerations, strictures and mucosal bridges. The histological finding of non caseating granulomata in oesophagus is observed in 20-30% of patients [4][5]. At the gastric and duodenal levels, typical endoscopic lesions include ulcerations (which can be linear, curve-shaped, diffuse, superficial or aphtous), nodularities, cobble-stone mucosa, bowel wall rigidity and luminal strictures [4][5].…”

“…UC was not traditionally associated to an extension involving more than colon and ileum. However, inflammatory lesions at the level of the upper gastrointestinal tract have recently been frequently observed also in UC patients (up to 70%) [4][5]. more rigid and diminishes the risk of loops formation; it requires, however, a peculiar attention of the operator for the risk of perforations, mainly for smaller children.…”

“…A colonscope with a diameter of 11.1-11.7 mm is therefore more indicated for the whole pediatric age [7][8]. Before any colonoscopy, it's good practice to perform a digital anal exploration and, subsequently, a rectal exploration in order to detect any possible lesion being localized at the lower segments; the retroversion of the colonoscope is also important for this purpose [4][5]. An adequate lubrication allows an easier transit through into the rectum, which can also be helped by the guide of the index finger of the operator [4][5].…”