Document Detail


High diagnostic yield of gastrointestinal endoscopy in children with intestinal failure.
MedLine Citation:
PMID:  18485964     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Children with intestinal failure (IF) often have gastrointestinal (GI) symptoms, including bleeding, increased stool output, and feeding intolerance. The use of endoscopic assessment of these symptoms has not been previously reported. This report evaluates the diagnostic yield of GI endoscopy in the setting of IF.
METHODS: After institutional review board approval, we reviewed the medical records (including endoscopy, pathology and microbiology data) of patients with IF who underwent GI endoscopies between September 1999 and March 2007.
RESULTS: Twenty-seven patients underwent 61 GI endoscopies: 34 esophagogastroduodenoscopies, 17 colonoscopies, 7 flexible sigmoidoscopies, and 3 ileoscopies. Indications for endoscopy, which were not mutually exclusive, included chronic diarrhea (39%, n = 24), GI bleeding (36%, n = 22), suspected bacterial overgrowth (36%, n = 22), and suspected peptic disease (15%, n = 9). Based on gross endoscopic appearance, histopathology, or microbiology, 43 (70%) procedures yielded abnormalities. These included infectious (20%, n = 12), anatomical (18%, n = 11), peptic (15%, n = 9), allergic (15%, n = 9), and other (2%, n = 1) findings. Eleven (73%) of 15 duodenal cultures grew a spectrum of 17 bacterial species. Overall, 24 (89%) of 27 patients had gross endoscopic, histopathologic, or microbiologic abnormalities.
CONCLUSIONS: In pediatric patients with IF, diagnostic upper and lower GI endoscopies yield high rates of abnormalities and can help guide clinical management.
Authors:
Y Avery Ching; Biren P Modi; Tom Jaksic; Christopher Duggan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  43     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-19     Completed Date:  2008-08-26     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  906-10     Citation Subset:  IM    
Affiliation:
Center for Advanced Intestinal Rehabilitation, Children's Hospital Boston and Harvard Medical School, Boston, MA 02215, USA. yching@bidmc.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Child, Preschool
Chronic Disease
Colonoscopy
Colony Count, Microbial
Diarrhea / diagnosis,  microbiology
Disease Progression
Duodenum / microbiology
Endoscopy, Gastrointestinal*
Female
Gastrointestinal Hemorrhage / diagnosis,  microbiology
Humans
Infant
Intestinal Diseases / classification,  diagnosis*,  microbiology*,  therapy
Intestine, Small / microbiology,  surgery
Male
Retrospective Studies
Short Bowel Syndrome / diagnosis,  microbiology
Grant Support
ID/Acronym/Agency:
P30 DK040561-13/DK/NIDDK NIH HHS
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