Gastrointestinal Endoscopy in Infants and Children

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Introduction The earliest gastrointestinal (GI) endoscopies were performed in the late 1880s by using rigid instruments to examine the esophagus and rectum. The semiflexible gastroscope was developed in the early 1930s by Schindler and Wolf, and fiberoptic endoscopes were popularized in the late 1960s and early 1970s. The first small-diameter instrument used for esophagogastroduodenoscopy (EGD) in a child was a fiberoptic bronchoscope. Video endoscopy has only developed over the past 2 decades, with the first mass-produced video instruments introduced in the 1980s. Parts or all of the procedure can be recorded for later review. Pediatric GI endoscopists can perform most of the endoscopic techniques of their adult counterparts. The referring physician and endoscopist should be familiar with the risks and benefits of endoscopy as well as clinical situations in which it is most useful. Personnel Specially trained pediatric endoscopy assistants are an important component of the endoscopy team. Preprocedure anxiety may be reduced by a physician, nurse, or play therapist explaining the procedure to the patient. One assistant can hold and reassure the child throughout the procedure while a second can help to obtain and process tissue and assist with other equipment and patient monitoring. Physicians performing GI endoscopy on infants and children should have completed a pediatric gastroenterology fellowship or have experience with pediatric gastrointestinal diseases and adequate training in pediatric endoscopy.