Title
Pediatric Endoscopy and High-risk Patients: A Clinical Report From the NASPGHAN Endoscopy Committee
UMMS Affiliation
Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics
Publication Date
2019-04-01
Document Type
Article
Disciplines
Analytical, Diagnostic and Therapeutic Techniques and Equipment | Digestive System Diseases | Gastroenterology | Health Services Administration | Pediatrics
Abstract
Pediatric gastrointestinal endoscopy has been established as safe and effective for diagnosis and management of many pediatric gastrointestinal diseases. Nevertheless, certain patient and procedure factors should be recognized that increase the risk of intra- and/or postprocedural adverse events (AEs). AEs associated with endoscopic procedures can broadly be categorized as involving sedation-related physiological changes, bleeding, perforation, and infection. Factors which may increase patient risk for such AEs include but are not limited to, cardiopulmonary diseases, anatomical airway or craniofacial abnormalities, compromised intestinal luminal wall integrity, coagulopathies, and compromised immune systems. Examples of high-risk patients include patients with congenital heart disease, craniofacial abnormalities, connective tissues diseases, inflammatory bowel disease, and children undergoing treatment for cancer. This clinical report is intended to help guide clinicians stratify patient risks and employ clinical practices that may minimize AEs during and after endoscopy. These include use of CO2 insufflation, endoscopic techniques for maneuvers such as biopsies, and endoscope loop-reduction to mitigate the risk of such complications such as bleeding and intestinal perforation. Endoscopic infection risk and guidance regarding periprocedural antibiotics are also discussed.
Keywords
adverse events, bleeding, endoscopy, pediatric
DOI of Published Version
10.1097/MPG.0000000000002277
Source
Lightdale JR, Liu QY, Sahn B, Troendle DM, Thomson M, Fishman DS; NASPGHAN Endoscopy and Procedures Committee. Pediatric Endoscopy and High-risk Patients: A Clinical Report From the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr. 2019 Apr;68(4):595-606. doi: 10.1097/MPG.0000000000002277. PMID: 30664560. Link to article on publisher's site
Journal/Book/Conference Title
Journal of pediatric gastroenterology and nutrition
Related Resources
PubMed ID
30664560
Repository Citation
Lightdale JR, Liu QY, Sahn B, Troendle DM, Thomson M, Fishman DS. (2019). Pediatric Endoscopy and High-risk Patients: A Clinical Report From the NASPGHAN Endoscopy Committee. Pediatric Publications. https://doi.org/10.1097/MPG.0000000000002277. Retrieved from https://escholarship.umassmed.edu/peds_pp/309