Role of colonoscopy in the diagnosis of lower gastrointestinal disorders in children

Abstract

Introduction Adult colonoscopies are widely and routinely performed worldwide and provide a safe and effective diagnostic and therapeutic tool. Moreover, safety and effectiveness of pediatric colonoscopy in lower gastrointestinal diseases have been established. Aim To assess the role of colonoscopy in the diagnosis of lower gastrointestinal tract diseases in a group of Egyptian children. Patients and methods A total of 40 children were admitted to the Endoscopy Unit of Al-Zahraa University Hospital, Al-Azhar University, in both Pediatric and Tropical Medicine Departments in the period from October 2014 to December 2015. They presented with various lower gastrointestinal symptoms, indicated for colonoscopy evaluation. Thorough clinical history taking and clinical examination, complete blood count, bleeding profile, liver enzymes, and kidney function tests were done. Colonoscopy and histopathological examination of colonoscopic specimen were done. Results The most common indications of colonoscopy were bleeding per rectum in 42.5% of cases followed by bleeding per rectum associated with chronic abdominal pain in 25% of cases, bleeding per rectum associated with vomiting, hematemesis, and melena in 15% of cases, bloody chronic diarrhea in 7.5% of cases, chronic constipation associated with bleeding per rectum in 5% of cases, and nonbloody chronic diarrhea in 5% of cases. Regarding endoscopic results, colorectal polyps, inflammation with superficial ulceration, and normal mucosa were the main endoscopic findings, representing 42.5, 37.5, and 20% of cases, respectively. Based on histopathological results, juvenile polyps were the most common diagnoses in 42.5% of cases, whereas 37.5% of cases were chronic nonspecific colitis, 12.5% of cases were eosinophilic colitis, and 7.5% of cases were ulcerative colitis. Conclusion Colonoscopy is a valuable and safe tool for diagnosis of lower gastrointestinal diseases in children.