Current role of colonoscopy in infants and young children: a multicenter study.

Autor: Nambu R; Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama-city, Saitama, 330-8777, Japan. nambee1231@gmail.com., Hagiwara SI; Division of General Pediatrics, Saitama Children's Medical Center, Saitama, Japan., Kakuta F; Division of General Pediatrics and Gastroenterology, Miyagi Children's Hospital, Miyagi, Japan., Hara T; Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama-city, Saitama, 330-8777, Japan., Shimizu H; Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan., Abukawa D; Division of General Pediatrics and Gastroenterology, Miyagi Children's Hospital, Miyagi, Japan., Iwama I; Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama-city, Saitama, 330-8777, Japan., Kagimoto S; Division of General Pediatrics, Saitama Children's Medical Center, Saitama, Japan., Arai K; Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan.
Jazyk: angličtina
Zdroj: BMC gastroenterology [BMC Gastroenterol] 2019 Aug 20; Vol. 19 (1), pp. 149. Date of Electronic Publication: 2019 Aug 20.
DOI: 10.1186/s12876-019-1060-7
Abstrakt: Background: To evaluate the role of colonoscopy in infants and young children and clarify the distribution of colonoscopy-requiring diseases in this age group.
Methods: Cohorts of colonoscopies performed at three children's hospitals in Japan between April 2011 and March 2016 including infants and children younger than six years of age were retrospectively reviewed.
Results: In total, 453 colonoscopies were performed in 276 infants and young children. Of these 275 (60.8%) were for diagnostic purposes, 177 (39.2%) were performed as follow-up, and one case was performed for treatment. The median patient age at the time of diagnostic colonoscopy was 2.49 years, and there was a male-to-female ratio of 1.72:1. Abnormal macroscopic and/or histopathological findings were noted in 212 (77.1%) cases. Of these, definite diagnoses were established for the presence of eosinophilic gastrointestinal disorders (EGIDs), inflammatory bowel disease (IBD), and polyp/polyposis in 23, 18.5, and 14% of patients, respectively. Among 51 IBD cases, ulcerative colitis, Crohn's disease, and IBD-unclassified were identified in 47.1, 33.3, and 7.8%, retrospectively via endoscopic examination. Of these, 11 (22%) were eventually diagnosed with monogenic diseases via genetic testing. Of those with rectal bleeding, EGIDs, polyps/polyposis, and IBD were found in 27, 19, and 18%, retrospectively. There were significantly more cases of EGIDs and fewer ones of IBD and polyps/polyposis in patients with rectal bleeding younger than two years of age. Furthermore, 68% of all follow-up colonoscopies were performed in children with IBD. There were no serious complications in our study cohort.
Conclusion: We determined the role of colonoscopy in infants and young children. Diseases diagnosed using colonoscopy in this age group included IBD, EGIDs, and polyps/polyposis. The increasing trend of patients with IBD and EGIDs worldwide means that the role of colonoscopy in infants and younger children will be more important in the future.
Databáze: MEDLINE
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