Abstract
ObjectiveTo investigate: 1) the demographics and clinical characteristics, 2) the findings, and 3) the safety and effectiveness in a cohort of Chinese pediatric patients undergoing colonoscopy.MethodsThe study participants were consecutive patients aged ≤14 years old that underwent their first colonoscopy in the endoscopy center at the First Affiliated Hospital, Sun Yat-sen University between Jan. 1, 2001 and Dec. 31, 2012. Demographic, clinical, endoscopic, and pathological findings were collected.ResultsThe cohort consisted of 322 patients, including 218 boys (67.7%) and 104 girls (32.3%). The median age was 8.0 years old and ranged from 9 months to 14 years old. Hematochezia (48.8%) and abdominal pain/discomfort (41.3%) were the most common presentations preceding pediatric colonoscopy. The caecal intubation success rate was 96.3%. No serious complications occurred during the procedures. A total of 227 patients (70.5%) received a positive diagnosis under endoscopy, including 138 patients with polyps and 53 patients with inflammatory bowel disease (IBD). Among the patients with polyps, 71.0% were juvenile polyps. Comparisons between years 2001–2006 and 2007–2012 showed that the IBD detection rate increased significantly (4.6% vs. 22.4%, P<0.001), while the opposite occurred for the polyp detection rate (73.1% vs. 27.6%, P<0.001).ConclusionColonoscopy in pediatric patients is a safe and effective procedure. Polyps are the primary finding during colonoscopy. In South China there has been an increase in pediatric patients diagnosed with IBD over the past decade. However, a large epidemiological study is needed to confirm our findings.
Highlights
Since its introduction in the late 1970s, the colonoscopy field has developed rapidly, especially in the 21st century [1,2]
Polyps are the primary finding during colonoscopy
In South China there has been an increase in pediatric patients diagnosed with inflammatory bowel disease (IBD) over the past decade
Summary
Since its introduction in the late 1970s, the colonoscopy field has developed rapidly, especially in the 21st century [1,2]. Colonoscopies are widely and routinely performed worldwide, both as a diagnostic and a therapeutic tool. The safety and effectiveness of diagnostic or therapeutic colonoscopies in adults has been well established in the past two decades [1,3]. Its utility for pediatric patients is only recently emerging. Major hurdles for pediatric colonoscopy include the high level of technical challenge, poor compliance with bowel cleansing, and uncooperativeness during the procedure. The slightly higher risk of severe complications when compared with adults might restrict its use in pediatric patients [1]
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