Electronic Endoscopy of the Upper Gastrointestinal Tract in Pediatric Patients

Seo, Jeong Wan

Abstract

PURPOSE
Since 1990 upper intestinal endoscopy has become frequently used tools for the diagnosis and treatment of a variety of upper intestinal tract disease. The purposes of this study was to assess the usefulness of small electronic endoscope in pediatric patients.
METHODS
Upper intestinal endoscopy was performed in 104 cases of children for 15 months using electronic endoscope (Olympus EVIS XQ 200, outer diameter 9.2 mm). During procedure all patients were lightly sedated with midazolam over 7 years or valium and demerol under 6 years.
RESULTS
The majority of cases were between 7-15 years of age and the youngest patient were 12 months of age. The indications in order of frequency were acute epigastric pain(41.3%), recurrent abdominal pain(17.3%), upper intestinal bleeding (13.5%), chronic dyspepsia and abdominal discomfort(9.6%), chest pain(3.8%), foreign body ingestion(3.8%), caustic ingestion(2.9%) and miscellaneous. The common abnormal endoscopic findings in order were gastritis(30.6%), ulcerative lesion(6.7%), duodenitis (6.7%). The 47.1 % of cases were endoscopically normal. Among 43 patients with acute epigastric pain, erosive gastritis(14.0%), nodular gastritis(11.6%), superficial gastritis (9.3%), duodenitis(9.3%), duodenal postbulbar ulcer(4.7%), esophagitis(2.3%), gastritis with duodenitis (2.3%) were diagnosed endoscopically. The rest of patients(44.2%) were normal. Twelve patients with upper gastrointestinal bleeding has erosive gastitis(16.7%), nodular gastritis(16.7%), gastric ulcer(16.7%). The rest(50.0%) were endoscopically normal. All 10 patients complaining chronic dyspepsia and abdominal discomfort showed abnormal findings such as erosive gastritis(30%), nodular gastritis(30%), superficial gastritis(40%). The 77.8% of patients with recurrent abdominal pain were normal and only 22.2% of patients showed superficial gastritis. The removal of foreign body was performed under the general anesthesia(3 cases) and light sedation(1 case). During and following endoscopy there was no significant complications.
CONCLUSIONS
In the hands of a skilled pedatric endoscopist, endoscopic procedures are not only enhance diagnostic accuracy but can performed safely. Small electronic endoscope widely used in adults has been safely adapted to children over 1 year of age.