The value of upper gastrointestinal endoscopy in children

Gryboski, Joyce D.

doi:10.1007/bf01300801

Cited by 21 publications

(10 citation statements)

References 21 publications

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“…In our case, the fact that direct pressure on the respiratory tract was applied by using an adult endoscope with a 9 mm diameter and that air had to be injected continually since the battery had attached itself to the esophagus and was hard to remove could have been some other causes for the excessive airway pressure, ventilation failure, and hypoxemia. When upper gastrointestinal endoscopic procedures were done on 99 infants of 0.9-10.1 kg using an endoscope with a 5.2 mm outer diameter, only 1 infant with global developmental delay exhibited hypoxemia [14], and Gryboski recommended using endoscopes with a 5 mm outer diameter on infants with esophageal diseases [15]. It is important to use pediatric endoscopes with the smallest possible outer diameters to prevent hypoxemia during endoscopic procedures on infants.…”

Section: Discussionmentioning

confidence: 99%

Compromised ventilation caused by tracheoesophageal fistula and gastrointestinal endoscope undergoing removal of disk battery on esophagus in pediatric patient -A case report-

Kim

et al. 2011

Korean J Anesthesiol

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Ingestion of disk batteries may have serious complications such as esophageal burn, perforation, and tracheoesophageal fistula, particularly when the battery is caught in the esophagus. Proper placement of the tracheal tube is critical when tracheoesophageal fistula was occurred from esophageal impaction the battery. Endoscopy of upper gastrointestinal tract in infants and children is an important and effective tool for the diagnosis and treatment of foreign body ingestion. But upper gastrointestinal endoscopy in infant and children has very high risk of tracheal compression and airway compromise. We present a case of ventilatory compromise during insertion of the upper gastrointestinal endoscopy in 16-month-old child with tracheoesophageal fistula secondary to disk battery ingestion.

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Section: Discussionmentioning

confidence: 99%

Compromised ventilation caused by tracheoesophageal fistula and gastrointestinal endoscope undergoing removal of disk battery on esophagus in pediatric patient -A case report-

Kim

et al. 2011

Korean J Anesthesiol

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“…Hargrove et al [5] have advo cated no sedation for children under 2 years of age. On the other hand, concerns about safety, especially airway compromise in these patients, have induced others to rec ommend general anesthesia or sedation in infants under 1 year of age [6,7], In older children and adolescents, it is routine to ad minister a sedative premedication to alle viate anxiety and to reduce restlessness with resultant diminution of pain and gag reflex.…”

mentioning

confidence: 99%

Randomized, Double-Blind Trial of Midazolam and Diazepam for Endoscopic Sedation in Children

Tolia

Fleming

Kauffman³

1990

Dev Pharmacol Ther

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We performed a prospective, randomized, double-blind study of 41 children (6-18 years of age) who were undergoing esophagogastroduodenoscopy (EGD) to compare the efficacy of diazepam and midazolam with respect to quality of sedation and amnesia. The endoscopist assessed the patients for control of salivation, gag reflex, vomiting and cooperation after intravenous injection of either 0.1-0.15 mg/kg of midazolam or 0.2-0.4 mg/kg of diazepam. The patients answered a questionnaire at 1 and 24 h after the procedure to assess recall of procedure details, pain and/or discomfort, and their medication choice for future procedures. Vital signs were monitored for 1 h after injection. Although midazolam caused greater mean maximum increase in heart rate than diazepam (30 vs. 14/min), no difference was found between the two treatment groups with respect to other vital signs. There was also no difference in physician’s assessment or patient recall of specific events during the procedure. However, significantly fewer patients recalled pain or discomfort with midazolam at both 1 and 24 h following the procedure (p = 0.02). In addition, more patients receiving midazolam indicated preference for the same sedation for future procedures. We conclude that midazolam may provide better amnesia in children undergoing endoscopic procedures.

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“…Diagnóstico: a EDA é superior aos estudos radiográfi-cos na localização dos sítios hemorrágicos 13,14 .…”

Section: Etapa Ii: Diagnóstico Etiológicounclassified

Gastrointestinal bleeding

Carvalho¹,

Nita²,

Paiva³

et al. 2000

J Pediatr (Rio J)

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ARTIGO DE REVISÃO ResumoObjetivo: Apresentar uma revisão sobre a ocorrência da hemorragia digestiva em crianças, com ênfase: i) na abordagem diagnós-tica; ii) no uso organizado das diversas modalidades terapêuticas utilizadas no controle da hemorragia digestiva alta; iii) na revisão de conceitos, classificações e técnicas utilizadas em endoscopia digestiva, importantes para a prática clínica pediátrica.Métodos: Foram selecionados capítulos de livros-textos, artigos relevantes ao tema, obtidos através do sistema Medline e busca ativa, bem como arquivos pessoais dos autores.Resultados: Na infância, o diagnóstico diferencial da hemorragia digestiva varia conforme a faixa etária avaliada. As causas de hemorragia digestiva alta são subdivididas em varicosas e não-varicosas. Os bloqueadores betadrenérgicos não-seletivos são indicados como profilaxia da HDA varicosa. As drogas vasoativas como a somatostatina, o octreotide e a glipressina são utilizadas, com bons resultados, na hemorragia aguda, varicosa e não-varicosa. Tanto a escleroterapia quanto a ligadura elástica podem ser utilizadas na infância, para obliteração das varizes esofágicas. O cianoacrilato é eficaz e associa-se a menor índice de complicações na HDA relacionada a varizes gástricas. A presença dos estigmas de hemorragia, como sangramento ativo e vaso visível nas lesões ulcerosas, indica um maior risco de recidiva hemorrágica, implicando a necessidade de hemostasia endoscópica. Os bloqueadores da bomba de prótons são mais eficazes que os bloqueadores H2 em promover a cicatrização das úlceras pépticas hemorrágicas.Conclusão: O conhecimento do diagnóstico etiológico em crianças com hemorragia digestiva é fundamental para a instituição da terapêutica adequada, cujos principais avanços se referem ao tratamento farmacológico e endoscópico. J. pediatr. (Rio J.). 2000; 76 (Supl.2): S135-S146: hemorragia digestiva alta, sangramento digestivo, endoscopia digestiva. AbstractObjective: To present an analysis of the occurrence of gastrointestinal bleeding in children and emphasize: i) diagnostic methods, ii) the organized use of different therapeutic approaches in upper gastrointestinal bleeding; iii) the review of concepts, classifications and techniques used in endoscopy which are important to the practice of clinical pediatrics.Methods: Literature review of selected chapters from coursebooks, articles pertinent to the theme, obtained through the Medline system and active search, as well as personal archives belonging to the authors. Results:The differential diagnosis of gastrointestinal bleeding in children varies according to age. The causes of upper gastrointestinal bleeding are subdivided into variceal and nonvariceal. Nonselective ß-blockers are recommended to prevent variceal bleeding. The vasoactive drugs such as somatostatin, octreotide, and glypressin can be used showing good results in both variceal and nonvariceal acute bleeding. Both sclerotherapy and variceal ligation can be used in children, to achieve variceal eradication. Cyanoacrylate is effective...

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The value of upper gastrointestinal endoscopy in children

Cited by 21 publications

References 21 publications

Compromised ventilation caused by tracheoesophageal fistula and gastrointestinal endoscope undergoing removal of disk battery on esophagus in pediatric patient -A case report-

Compromised ventilation caused by tracheoesophageal fistula and gastrointestinal endoscope undergoing removal of disk battery on esophagus in pediatric patient -A case report-

Randomized, Double-Blind Trial of Midazolam and Diazepam for Endoscopic Sedation in Children

Gastrointestinal bleeding

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