Study to determine guidelines for pediatric colonoscopy

World J Gastroenterol. 2017 Aug 21;23(31):5773-5779. doi: 10.3748/wjg.v23.i31.5773.

Abstract

Aim: To investigated characteristics, diagnosis, bowel-cleansing preparation, sedation, and colonoscope length and diameter in Japanese pediatric patients receiving total colonoscopy.

Methods: The present study evaluated consecutive patients aged ≤ 15 years who had undergone their first colonoscopy in Kurume University between January 2007 and February 2015. Data were retrospectively analyzed. We identified 110 pediatric patients who had undergone colonoscopy that had reached the cecum, allowing the observation of the total colon.

Results: Hematochezia, abdominal pain, and diarrhea were the most common symptoms. For bowel-cleansing preparation, pediatric patients aged ≤ 12 years were treated with magnesium citrate, and patients aged 13-15 years were treated with polyethylene glycol 4000. For sedation, thiamylal with pentazocine, which has an analgesic effect, was used in patients aged ≤ 6 years, and midazolam with pentazocine was used in patients aged ≥ 7 years. Regarding the choice of endoscope, short and thin endoscopes were selected for younger patients, particularly patients aged ≤ 3 years. Positive diagnoses were made in 78 patients (70.9%). Inflammatory bowel disease (n = 49, 44.5%), including ulcerative colitis (n = 37, 33.6%) and Crohn's disease (n = 12, 10.9%), was the most common diagnosis.

Conclusion: Colonoscopy offers a high diagnostic capability for pediatric patients with gastrointestinal symptoms. The selection of appropriate management the performance of colonoscopy is important in pediatric patients.

Keywords: Bowel cleansing preparation; Complication; Inflammatory bowel disease; Pediatric endoscopy; Sedation.

Publication types

  • Evaluation Study

MeSH terms

  • Abdominal Pain / diagnostic imaging*
  • Adolescent
  • Age Factors
  • Cathartics / administration & dosage*
  • Child
  • Child, Preschool
  • Citric Acid / administration & dosage
  • Colon / diagnostic imaging
  • Colon / drug effects
  • Colonoscopes
  • Colonoscopy / adverse effects
  • Colonoscopy / instrumentation
  • Colonoscopy / methods
  • Colonoscopy / standards*
  • Diarrhea / diagnostic imaging*
  • Female
  • Gastrointestinal Hemorrhage / diagnostic imaging*
  • Humans
  • Hypnotics and Sedatives / administration & dosage*
  • Infant
  • Infant, Newborn
  • Japan
  • Male
  • Organometallic Compounds / administration & dosage
  • Polyethylene Glycols / administration & dosage
  • Practice Guidelines as Topic
  • Propofol / administration & dosage
  • Retrospective Studies

Substances

  • Cathartics
  • Hypnotics and Sedatives
  • Organometallic Compounds
  • Citric Acid
  • Polyethylene Glycols
  • polyethylene glycol 4000
  • magnesium citrate
  • Propofol