Published online Aug 21, 2017. doi: 10.3748/wjg.v23.i31.5773
Peer-review started: April 27, 2017
First decision: June 8, 2017
Revised: June 23, 2017
Accepted: July 12, 2017
Article in press: July 12, 2017
Published online: August 21, 2017
Processing time: 115 Days and 0.1 Hours
To investigated characteristics, diagnosis, bowel-cleansing preparation, sedation, and colonoscope length and diameter in Japanese pediatric patients receiving total colonoscopy.
The present study evaluated consecutive patients aged ≤ 15 years who had undergone their first colonoscopy in Kurume University between January 2007 and February 2015. Data were retrospectively analyzed. We identified 110 pediatric patients who had undergone colonoscopy that had reached the cecum, allowing the observation of the total colon.
Hematochezia, abdominal pain, and diarrhea were the most common symptoms. For bowel-cleansing preparation, pediatric patients aged ≤ 12 years were treated with magnesium citrate, and patients aged 13-15 years were treated with polyethylene glycol 4000. For sedation, thiamylal with pentazocine, which has an analgesic effect, was used in patients aged ≤ 6 years, and midazolam with pentazocine was used in patients aged ≥ 7 years. Regarding the choice of endoscope, short and thin endoscopes were selected for younger patients, particularly patients aged ≤ 3 years. Positive diagnoses were made in 78 patients (70.9%). Inflammatory bowel disease (n = 49, 44.5%), including ulcerative colitis (n = 37, 33.6%) and Crohn’s disease (n = 12, 10.9%), was the most common diagnosis.
Colonoscopy offers a high diagnostic capability for pediatric patients with gastrointestinal symptoms. The selection of appropriate management the performance of colonoscopy is important in pediatric patients.
Core tip: A guideline for pediatric colonoscopy management have yet to be established in Japan. We investigated clinical characteristics, diagnostic utility, bowel cleansing preparation, sedation, and colonoscope length and diameter under 15 years of age who had undergone their first colonoscopy in our institution. Our results revealed that the symptoms associated with the indication of pediatric colonoscopy were hematochezia, abdominal pain, and diarrhea. Positive diagnoses were obtained in a majority of pediatric patients. More than 40% of patients were diagnosed with inflammatory bowel disease. Thus, our findings demonstrate the utility of colonoscopy as a diagnostic tool in pediatric patients with gastrointestinal symptoms.