Abstract
Advances in endoscopy and anesthesia have enabled gastrointestinal endoscopy for children since 1960. Over the past decades, the number of endoscopies has increased rapidly. As specialized teams of pediatric gastroenterologists, pediatric intensive care physicians and pediatric endoscopy nurses are available in many medical centers, safe and effective procedures have been established. Therefore, diagnostic endoscopies in children are routine clinical procedures. The most frequently performed endoscopies are esophagogastroduodenoscopy (EGD), colonoscopy and endoscopic retrograde cholangiopancreaticography (ERCP). Therapeutic interventions include variceal bleeding ligation, foreign body retrieval and percutaneous endoscopic gastrostomy. New advances in pediatric endoscopy have led to more sensitive diagnostics of common pediatric gastrointestinal disorders, such as Crohn’s disease, ulcerative colitis and celiac disease; likewise, new diseases, such as eosinophilic esophagitis, have been brought to light.Upcoming modalities, such as capsule endoscopy, double balloon enteroscopy and narrow band imaging, are being established and may contribute to diagnostics in pediatric gastroenterology in the future.
Highlights
Since its introduction in the 1960s, the field of pediatric gastroenterology has developed rapidly
Pediatric gastroenterology has become a subspecialty in many countries
With the development of a subspecialty focused on disorders of the pediatric gastrointestinal (GI) tract, new technologies such as pediatric endoscopy were developed to aid in diagnoses
Summary
Since its introduction (or first descpription) in the 1960s, the field of pediatric gastroenterology has developed rapidly. The recognition of EoE as a distinct clinical entity from gastroesophageal reflux disease (GERD) and functional abdominal pain has increased the use of pediatric EGD in the last decade as an important diagnostic modality for a disorder that can otherwise not be diagnosed. Since IBD presents in 25% to 30% of patients before the age of 20 years and polyps are the most common causes of rectal bleeding in children, these two diagnostic categories are the most common diagnoses in pediatric lower gastrointestinal disorders. DBE appears to be a safe endoscopic modality for children, it is quite invasive and should be selectively reserved for patients with a high suspicion for small intestinal pathology, in which other invasive techniques have failed to adequately diagnose and treat a patient’s disease. The relevance of both techniques in pediatric routine clinical diagnosis has to be shown in future studies
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