Eus-Guided Hotaxios for the Treatment of Traumatic Pancreatic Pseudocyst in Pediatric Patient

Ardengh, José Celso; Taglieri, Eloy; Ardengh, André Orsini; Micelli-Neto, Otávio; Machado, Marcel Autran

doi:10.1590/s0004-2803.202000000-61

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…Of late, there have been some unique pediatric cases that have been successfully managed. EUS-guided HotAxios was used to treat a traumatic pancreatic pseudocyst in a 12-year-old child by Ardengh JC et al in 2020 28 . EUS-guided pancreatic duct rendezvous was done in a child with traumatic pancreatic duct disruption 29 .…”

Section: Discussionmentioning

confidence: 99%

Usefulness of endoscopic ultrasound in children with pancreatobiliary and gastrointestinal symptoms

et al. 2022

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Background and study aims Endoscopic ultrasound (EUS) is useful in diagnosing and treating childhood pancreatobiliary and gastrointestinal diseases. However, there are limited data on its effectiveness for various indications. Patients and methods This was a retrospective analysis of prospectively collected data of patients who underwent EUS for upper gastrointestinal tract disorders from January 2018 to December 2020 to assess its indications, findings, interventions, and complications. Results Ninety-two procedures were performed in 85 children, (70.5 % male; mean [SD] age 12.1 years [3.9] years) with a mean (SD) symptom duration of 1.1 (0.5) years. The procedures were technically successful in all patients. The primary indication for EUS was abdominal pain in 45(52.9%) and jaundice/cholangitis in 15 patients (17.6 %). General anesthesia was used in 12 (13 %) and TIVA in 80 patients (87 %). The most common diagnostic findings were choledocholithiasis in 21 (24.7 %) and cholelithiasis in 12 patients (14.1 %). Among interventions, EUS-guided cystogastrostomy for pancreatic pseudocyst was done in four patients (4.7 %), and EUS-guided rendezvous for failed ERCP in one patient (1.2 %) with cholangitis. There were no immediate post-procedural complications. Overall, EUS had a meaningful impact on the subsequent clinical management in 69 cases (81.2 %). Conclusions EUS in the pediatric population is safe, effective, and has a meaningful impact in appropriately selected cases. It can act as a rescue in major therapeutic procedures, but adequate care should be taken at the procedural level and during anesthesia.

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Section: Discussionmentioning

confidence: 99%

Usefulness of endoscopic ultrasound in children with pancreatobiliary and gastrointestinal symptoms

et al. 2022

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“…Overall, EUS findings modified the diagnostic or treatment strategy in 87 patients (80.5%). This high performance can be explained by the conclusive diagnoses made in pancreatobiliary diseases, such as chronic pancreatitis (9) , microlithiasis (13) , and pancreatic masses (27) .…”

Section: Discussionmentioning

confidence: 99%

“…Conventional drainage was performed with excellent results. EUS-D was performed with the implantation of double-pigtail plastic stents following fistula dilation (7) and a hot AXIOS self-expandable metal stent implantation in one case of pancreatic pseudocyst (a 12-yearold boy who presented with pancreatic fracture due to abdominal trauma) (27) . In the present case series, pancreatic pseudocyst was the most common occurrence, consistent with the findings of other published series (28) .…”

Section: Discussionmentioning

confidence: 99%

Impact of Diagnostic and Interventional Endoscopic Ultrasonography in Children

Garcia

Taglieri

Micelli-Neto

et al. 2022

Arq. Gastroenterol.

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Background: Endoscopic ultrasonography is used in the diagnosis and treatment of digestive diseases in adults. In children, its use is limited due to a lack of available expertise. Objective: This study aimed to evaluate the clinical impact of endoscopic ultrasonography on diagnostic and therapeutic strategy changes in pediatric patients. Methods: Over ten years, this study retrospectively and consecutively analyzed children aged ≤18 years who underwent endoscopic ultrasonography because of inconclusive imaging or laboratory tests. The indications, results, occurrence of adverse events, and clinical impact of the procedures were analyzed. The clinical impact was classified as major (when the findings led to changes in diagnosis and management), minor (change in diagnosis but not in management), or none (no change in diagnosis or management). Results: Overall, 107 children [77 (72%) of whom were female; mean age: 11.7 ± 4 years] underwent upper [102 (95.3%)] and lower [5 (4.7%)] endoscopic ultrasonography; 64 (58%) patients underwent diagnostic endoscopic ultrasonography, and 43 (42%) underwent interventional endoscopic ultrasonography. Endoscopic ultrasonography was used to investigate pancreaticobiliary, gastric, rectal, esophageal, duodenal, and mediastinal diseases in 81 (76%), 14 (13%), 5 (4.6%), 3 (2.8%), 2 (1.8%), and 2 (1.8%) patients, respectively. The clinical impact was significant in 81% of the children. Major and no clinical impact on pancreaticobiliary, gastrointestinal diseases, and mediastinal masses occurred in 50 (62%) and 13 (16%), 13 (54%) and 9 (37%), and 2 (100%) and 0 (0%) of the patients, respectively. Conclusion: This study evaluated the impact of diagnostic and interventional endoscopic ultrasonography in pediatric patients. When clinically and appropriately indicated, these procedures are safe and effective diagnostic or therapeutic interventions in pediatric patients with gastrointestinal or pancreaticobiliary disorders.

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Recent progress and current status of pancreatobiliary interventional endoscopic ultrasound in children

Ishii,

Isayama,

Suzuki

et al. 2024

Digestive Endoscopy

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In recent years, the usefulness of endoscopic ultrasound (EUS) has been recognized in children. A dedicated pediatric EUS scope has not been developed; in our experience, however, an adult EUS scope can be used. The American Society for Gastrointestinal Endoscopy Technical Committee status assessment report on pediatric endoscopy equipment provides some guidance on the feasibility of EUS according to body size. Careful monitoring is required, keeping in mind potential adverse events such as cervical esophageal perforation and unstable breathing due to tracheal compression. Most devices designed for interventional pancreatobiliary endoscopy are also available for children. Sedation or intubated general anesthesia (GA) is mandatory when performing interventional EUS (I‐EUS). I‐EUS for children is generally performed using GA in the operating room, but sedation in the endoscopy room is also possible under appropriate monitoring by pediatricians. I‐EUS in the operating room is sometimes difficult for endoscopists to perform because of the unsuitable fluoroscopic imaging and the lack of familiar equipment and staff. Compared to GA, sedation in the endoscopy room facilitates easier and quicker repetition of procedures when necessary. Adult pancreatobiliary endoscopists perform most I‐EUS procedures in the pediatric population because most pediatric endoscopists have few opportunities to perform EUS‐related procedures and thus have difficulty maintaining their skills. To popularize I‐EUS techniques for children, it will be necessary to establish a training program for developing pediatric endoscopists.

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Eus-Guided Hotaxios for the Treatment of Traumatic Pancreatic Pseudocyst in Pediatric Patient

Cited by 3 publications

References 6 publications

Usefulness of endoscopic ultrasound in children with pancreatobiliary and gastrointestinal symptoms

Usefulness of endoscopic ultrasound in children with pancreatobiliary and gastrointestinal symptoms

Impact of Diagnostic and Interventional Endoscopic Ultrasonography in Children

Recent progress and current status of pancreatobiliary interventional endoscopic ultrasound in children

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