OBJECTIVES: Rectal bleeding is an alarming event both for the child and parents. It is hypothesized that colonoscopy instead of sigmoidoscopy and adding esophago-gastro-duodenoscopy in case of accompanying complaints, improves the diagnostic accuracy in children with prolonged rectal bleeding. STUDY DESIGN: All pediatric patients undergoing colonoscopy because of prolonged rectal bleeding over an 8-year period at the Emma Children's Hospital/Academic Medical Centre were reviewed. Patient demographics, clinical features, number and extent of endoscopic examinations and the endoscopic and histopathological findings were assessed. RESULTS: A total of 147 colonoscopies were performed in 137 pediatric patients (63 boys) because of prolonged rectal bleeding. Inflammatory bowel disease and polyp(s) were the most prevalent diagnoses. In 72% of patients diagnosed as Crohn's disease, focal, chronically active gastritis was seen on histology, giving support to the diagnosis Crohn's disease. In 22% of the cases polyps would have been missed in the case where only sigmoidoscopy was performed. No complications after endoscopic intervention were seen. CONCLUSIONS: Colonoscopy is the investigation of choice in children with prolonged rectal bleeding. In patients presenting with accompanying complaints such as abdominal pain or diarrhea, it is advisable to perform ileocolonoscopy combined with esophago-gastro-duodenoscopy. This combines a high diagnostic yield with a safe procedure.
OBJECTIVES: Rectal bleeding is an alarming event both for the child and parents. It is hypothesized that colonoscopy instead of sigmoidoscopy and adding esophago-gastro-duodenoscopy in case of accompanying complaints, improves the diagnostic accuracy in children with prolonged rectal bleeding. STUDY DESIGN: All pediatric patients undergoing colonoscopy because of prolonged rectal bleeding over an 8-year period at the Emma Children's Hospital/Academic Medical Centre were reviewed. Patient demographics, clinical features, number and extent of endoscopic examinations and the endoscopic and histopathological findings were assessed. RESULTS: A total of 147 colonoscopies were performed in 137 pediatric patients (63 boys) because of prolonged rectal bleeding. Inflammatory bowel disease and polyp(s) were the most prevalent diagnoses. In 72% of patients diagnosed as Crohn's disease, focal, chronically active gastritis was seen on histology, giving support to the diagnosis Crohn's disease. In 22% of the cases polyps would have been missed in the case where only sigmoidoscopy was performed. No complications after endoscopic intervention were seen. CONCLUSIONS: Colonoscopy is the investigation of choice in children with prolonged rectal bleeding. In patients presenting with accompanying complaints such as abdominal pain or diarrhea, it is advisable to perform ileocolonoscopy combined with esophago-gastro-duodenoscopy. This combines a high diagnostic yield with a safe procedure.
Authors: Yuk Him Tam; Kim Hung Lee; Kin Wai Chan; Jennifer Dart Yin Sihoe; Sing Tak Cheung; Jennifer Wai Cheung Mou Journal: World J Gastroenterol Date: 2010-03-07 Impact factor: 5.742
Authors: Francesco Esposito; Marco Di Serafino; Carmela Mercogliano; Dolores Ferrara; Norberto Vezzali; Giovanni Di Nardo; Luigi Martemucci; Gianfranco Vallone; Massimo Zeccolini Journal: J Ultrasound Date: 2019-02-13
Authors: Laura Stampfer; Andrea Deutschmann; Elisabeth Dür; Franz G Eitelberger; Theresia Fürpass; Gregor Gorkiewicz; Peter Heinz-Erian; Ingrid Heller; Kathrin Herzog; Barbara Hopfer; Reinhold Kerbl; Evelyn Klug; Robert Krause; Eva Leitner; Christoph Mache; Thomas Müller; Jasmin Pansy; Mirjam Pocivalnik; Eva Scheuba; Georg Schneditz; Gerolf Schweintzger; Edith Sterniczky; Ellen Zechner; Almuthe C Hauer; Christoph Högenauer; Karl Martin Hoffmann Journal: Medicine (Baltimore) Date: 2017-08 Impact factor: 1.889