Korean J Pediatr Gastroenterol Nutr.  2011 Dec;14(4):368-375. 10.5223/kjpgn.2011.14.4.368.

Diagnostic Yield of Pediatric Colonoscopies Based on Presenting Symptoms in a Secondary Hospital

• Cho YJ
• Cho IH
• Yoo HJ
• Choi H
• Lee BI
• Kim SY
• Jeong DC
• Chung SY
• Kang JH

• KMID: 2277708
• DOI: http://doi.org/10.5223/kjpgn.2011.14.4.368

Abstract

PURPOSE
We performed this study retrospectively to review the diagnostic yield of colonoscopies in children and adolescents with various gastrointestinal symptoms and to investigate the relationship between presenting symptoms and the colonoscopic findings in a secondary hospital.
METHODS
We reviewed the medical records of patients under the age of 19-years who underwent ileocolonoscopy between January 2001 and December 2010. The total number of patients (n=238) were divided into three age groups and six symptom groups. We analyzed clinical characteristics and the colonoscopic findings, and compared the colonoscopic yield between each groups.
RESULTS
The median age of the patients was 16.1 (3.1~18.9) years. The most common presenting symptoms were lower gastrointestinal (GI) bleeding (48.1%) in the < or =12 years group (n=27), chronic abdominal pain (31.8%) in the 13~15 years group (n=85), and chronic diarrhea (34.9%) in the > or =16 years group (n=126). Positive colonoscopic findings were found in 21.4% of the bowel habit change group (n=28), 51.9% of the low GI bleeding group (n=54), 37.7% of the chronic diarrhea group (n=69), and 94.4% of the group with suspected inflammatory bowel disease (IBD) (n=18), 38.9% of the chronic abdominal pain group (n=54) and 13.3% of the anemia group (n=15). The diagnostic yield of the total examination was 42.0%. The suspected IBD group had a higher yield than the presenting symptom groups (p<0.001).
CONCLUSION
Colonoscopy is a safe and useful investigation in children and adolescents with suspected colonic disease. The diagnostic yield of colonoscopy is higher in patients presenting with suspected IBD. Pediatricians practicing in primary or secondary care settings should recommend colonoscopy for patients with suspected IBD.

Keyword

Colonoscopy; Diagnostic yield; Presenting symptoms

MeSH Terms

Abdominal Pain
Adolescent
Anemia
Child
Colonic Diseases
Colonoscopy
Diarrhea
Hemorrhage
Humans
Inflammatory Bowel Diseases
Medical Records
Retrospective Studies
Secondary Care

Figure

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  Fig. 1 Distribution of colonoscopic findings according to age groups. IBD: inflammatory bowel disease, IC: infectious colitis, LNH: lymphoid nodular hyperplasia.

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  Fig. 2 Distribution of colonoscopic findings according to presenting symptoms. IBD: inflammatory bowel disease, IC: infectious colitis, LNH: lymphoid nodular hyperplasia.

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  Fig. 3 Diagnostic yields based on presenting symptoms. Colonoscopic studies in patients with suspected IBD had a higher yield than other presenting symptoms. The diagnostic yield of bowel habit change and anemia group was significantly lower compared with the total yield. GI: gastrointestinal, IBD: inflammatory bowel disease.

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