• pediatric gastrointestinal endoscopy
• quality improvement
• safety

• Humans
• Electronic Health Records
• Child
• Female
• Male
• Child, Preschool
• Infant
• Conscious Sedation/adverse effects
• Conscious Sedation/methods
• Endoscopy, Gastrointestinal/adverse effects
• Endoscopy, Gastrointestinal/methods
• Adolescent
• Hospitals, Pediatric
• Retrospective Studies

• celiac disease
• cystic fibrosis
• endoscopy
• eosinophilic esophagitis
• gastrointestinal
• pediatric

• Child
• Endoscopy
• Gastrointestinal tract
• Risk factors

• Asia
• Children
• Colonoscopy
• Endoscopy
• Gastroscopy
• Paediatric

• Humans
• Child
• Artificial Intelligence
• Helicobacter Infections/complications
• Helicobacter pylori
• Capsule Endoscopy/adverse effects
• Gastrointestinal Hemorrhage/etiology
• Gastrointestinal Hemorrhage/therapy
• Gastrointestinal Hemorrhage/diagnosis
• Inflammatory Bowel Diseases/complications
• Intestinal Polyposis/complications
• Gastritis
• Pediatrics

Gastrointestinal bleeding (GIB) is a serious health problem worldwide, particularly during childhood. This can be an alarming sign of an underlying disease. Gastrointestinal endoscopy (GIE) is a safe method for the diagnosis and treatment of GIB in most cases.

To determine the incidence, clinical presentation, and outcomes of GIB in children in Bahrain over the last two decades.

This was a retrospective cohort review of the medical records of children with GIB who underwent endoscopic procedures in the Pediatric Department at Salmaniya Medical Complex, Bahrain, between 1995 and 2022. Demographic data, clinical presentation, endoscopic findings, and clinical outcomes were recorded. GIB was classified into upper (UGIB) and lower (LGIB) GIB according to the site of bleeding. These were compared with respect to patients’ sex, age, and nationality using the Fisher’s exact, Pearson’s χ², or the Mann-Whitney U tests.

A total of 250 patients were included in this study. The median incidence was 2.6/100000 per year (interquartile range, 1.4-3.7) with a significantly increasing trend over the last two decades (P < 0.0001). Most patients were males (n = 144, 57.6%). The median age at diagnosis was 9 years (5–11). Ninety-eight (39.2%) patients required upper GIE alone, 41 (16.4%) required colonoscopy alone, and 111 (44.4%) required both. LGIB was more frequent (n = 151, 60.4%) than UGIB (n = 119, 47.6%). There were no significant differences in sex (P = 0.710), age (P = 0.185), or nationality (P = 0.525) between the two groups. Abnormal endoscopic findings were detected in 226 (90.4%) patients. The common cause of LGIB was inflammatory bowel disease (IBD) (n = 77, 30.8%). The common cause of UGIB was gastritis (n = 70, 28%). IBD and undetermined cause for bleeding were higher in the 10–18 years group (P = 0.026 and P = 0.017, respectively). Intestinal nodular lymphoid hyperplasia, foreign body ingestion, and esophageal varices were more common in the 0–4 years group (P = 0.034, P < 0.0001, and P = 0.029, respectively). Ten (4%) patients underwent one or more therapeutic interventions. The median follow-up period was two years (0.5-3). No mortality was reported in this study.

GIB in children is an alarming condition, whose significance is increasing. LGIB, commonly due to IBD, was more common than UGIB, commonly due to gastritis.

• Pediatric
• Gastrointestinal bleeding
• Endoscopy
• Causes
• Outcome
• Bahrain

• Health services research
• Health systems
• Public Health
• Systematic review

• Humans
• Developing Countries
• Overdiagnosis
• Poverty
• Health Services
• Government Programs

• National Health and Medical Research Council

Large-scale data on esophagogastroduodenoscopy (EGD) in China are scarce. This study aimed to assess the indications and diagnostic yield of EGD in children and the relationship between factors (such as age, sex, and indications) and diagnostic yield.

We performed a prospective cross-sectional observational study involving patients aged < 18 years who underwent diagnostic EGD. The study was conducted in five children’s hospitals, each in a different city. Demographic features, indications for endoscopy, and endoscopic and histopathological findings were collected. Univariable and multivariable ordinal logistic regression analyses of the relationship between the factors and diagnostic yield were performed.

The study included 2268 patients (male/female ratio, 1.3:1) with a median age of 8.68 years. Among the 2268 children, the most frequent indications were abdominal pain in 1954 (86.2%), recurrent vomiting in 706 (31.1%), weight loss in 343 (15.1%), and others. The endoscopic yield was 62.5% and was the highest in patients with dysphagia (90.9%). The histologic yield was 30.4% and was the highest in patients with unexplained anemia (45.5%). On multivariable regression analysis, the endoscopic yield was associated with dysphagia, gastrointestinal (GI) bleeding, and recurrent vomiting, and the histologic yield was associated with age. Different groups of patients with abdominal pain had variable probabilities of abnormal endoscopic findings.

The most frequent indication of pediatric EGD is abdominal pain, with variable probabilities of abnormal endoscopic findings in different groups. Endoscopic yield and histologic yield are associated with certain alarming features.

The trial registration number (ClinicalTrials. gov): NCT03603093 (The study was registered on 27/07/2018).

• Abdominal pain
• Endoscopic yield
• Histologic yield
• Persistent vomiting
• Regression analyses

• Endoscopy
• GASTROENTEROLOGY
• Paediatric gastroenterology

• Humans
• Child
• Cross-Sectional Studies
• Retrospective Studies
• Endoscopy, Gastrointestinal
• Gastrointestinal Tract
• Gastroenterology
• Pediatrics

• Child
• Consensus
• Delphi Technique
• Endoscopy, Gastrointestinal
• Gastroenterology
• Humans
• Quality Improvement

• Complications
• Paediatric endoscopy
• Quality indicator
• Terminal ileal intubation

• Celiac Disease
• Child
• Endoscopy, Gastrointestinal/adverse effects
• Female
• Hospitals, General
• Humans
• Inflammatory Bowel Diseases
• Male
• Retrospective Studies

• Abdominal pain
• Appropriate, Children
• Children
• Endoscopy
• Gastritis
• Histology

• diagnostic yield
• gastrointestinal endoscopy
• indications
• pediatric
• resource allocation

• Child
• Complications
• Endoscopy

• Diagnostic yield
• Endoscopic procedure
• Esophago-gastro-duodenoscopy
• Ileo-colonoscopy

• children
• endoscopy
• gastrointestinal graft-versus-host disease
• hematopoietic stem cell transplantation
• histopathology
• treatment change

To study implications of measuring quality indicators on training and trainees’ performance in pediatric colonoscopy in a low-volume training center.

We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years (January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks.

Median (± SD) age of 121 children [males = 74 (61.2%)] who had 177 colonoscopies was 7.0 (± 4.6) years. On average, 30 colonoscopies were performed each year (range: 19-58). Except for investigations of abdominal pain (21/177, 17%), indications for colonoscopies were appropriate in the remaining 83%. Bowel preparation was good in 87%. One patient (0.6%) with severe Crohn’s disease had bowel perforation. Cecum examination and ileal intubation rate was 95% and 68.1%. Ileal intubation rate was significantly higher in diagnosing or assessing inflammatory bowel disease (IBD) than non-IBD (72.9% vs 50.0% P = 0.016). Performance of four trainees was consistent throughout the study period. Average cecum and ileal examination rate among trainees were 97% and 77%.

Benchmarking against established guidelines helps units with a low-volume of colonoscopies to identify area for further improvement.

• Pediatric colonoscopies
• Quality indicators
• Performance

• Benchmarking/standards
• Child
• Child, Preschool
• Clinical Competence/standards
• Colonoscopy/adverse effects
• Colonoscopy/education
• Colonoscopy/standards
• Education, Medical, Graduate/standards
• Female
• Gastroenterology/education
• Gastroenterology/standards
• Hospitals, Low-Volume/standards
• Humans
• Male
• Pediatrics/education
• Pediatrics/standards
• Predictive Value of Tests
• Quality Improvement/standards
• Quality Indicators, Health Care/standards
• Retrospective Studies

• abdominal pain
• children
• endoscopy

• Adolescent
• Caustics
• Child
• Child, Preschool
• Cholangiopancreatography, Endoscopic Retrograde
• Colonoscopy
• Endoscopy, Digestive System
• Endoscopy, Gastrointestinal/standards
• Endosonography
• Europe
• Female
• Foreign Bodies
• Gastroenterology
• Gastrointestinal Diseases/diagnosis
• Gastrointestinal Diseases/therapy
• Gastrointestinal Hemorrhage
• Humans
• Infant
• Infant, Newborn
• Male
• Pediatrics
• Societies

• Gastroenterology
• General Paediatrics

The best modality for foreign body removal has been the subject of much controversy over the years. We have read with great interest the recent article by Souza Aguiar Municipal Hospital, Rio de Janeiro, Brazil, describing their experience with the management of esophageal foreign bodies in children. Non-endoscopic methods of removing foreign bodies (such as a Foley catheter guided or not by fluoroscopy) have been successfully used at this center. These methods could be an attractive option because of the following advantages: Shorter hospitalization time; easy to perform; no need for anesthesia; avoids esophagoscopy; and lower costs. However, the complications of these procedures can be severe and potentially fatal if not performed correctly, such as bronchoaspiration, perforation, and acute airway obstruction. In addition, it has some disadvantages, such as the inability to directly view the esophagus and the inability to always retrieve foreign bodies. Therefore, in Western countries clinical practice usually recommends endoscopic removal of foreign bodies under direct vision and with airway protection whenever possible.

• Foreign bodies
• Children
• Foley catheter
• Flexible endoscopy

After the introduction of flexible fiber optic endoscopy to pediatric gastroenterology in the 1970s, upper gastrointestinal (UGI) endoscopy can be performed for the diagnosis and treatment of all age groups of children. We review indications, contraindications, preparation of patients for the procedure, and details of diagnostic and therapeutic UGI endoscopy used in pediatric surgery. We also discuss potential complications of endoscopy.

• Endoscopy
• Upper gastrointestinal system
• Pediatric surgery
• Diagnosis
• Treatment

• endoscopy
• gastroenterology
• gastrointestinal
• ile-ife
• nigeria
• paediatrics