Upper gastrointestinal endoscopy in pediatric gastroenterology: Diagnostic and therapeutic applications

Table 1 Diagnostic and therapeutic indications of upper gastrointestinal endoscopy in children

Diagnostic indications	Therapeutic indications
Weight loss, failure to thrive	Percutaneous endoscopic gastrostomy (re)placement
Unexplained anemia	Duodenal tube placement
Abdominal pain with suspicion of an organic disease	Foreign body removal
	Food impaction
	Hemostasis
Dysphagia or odynophagia	Esophageal varices
Recurrent vomiting with unknown cause	Percutaneous jejunostomy placement
Hematemesis	Perforation
Hematochezia	Achalasia
Unexplained chronic diarrhea	Dilatation of esophageal or upper GI strictures
Suspicion of graft vs host disease	Polypectomy
Chronic GERD, to exclude other diseases, or surveillance of Barrett’s esophagus

GERD: Gastroesophageal reflux disease; GI: Gastrointestinal.

Table 2 Absolute and relative contraindications for upper gastrointestinal endoscopy in children

Absolute contraindications	Relative contraindications
Unstable airway	Bowel obstruction
Cardiovascular collapse	Severe thrombocytopenia
Intestinal perforation	Coagulopathy
Peritonitis	Recent GI surgery
	Respiratory infection
	Recent food intake

GI: Gastrointestinal.

Table 3 Cardiac conditions with a high risk of infective endocarditis during endoscopic procedures

List of cardiac conditions
(1) Prosthetic (mechanical or bioprosthetic) cardiac valves
(2) History of previous IE
(3) Cardiac transplant recipients who develop cardiac valvulopathy
(4) Patients with CHD: Unrepaired cyanotic CHD, including palliative shunts and conduits; those with completely repaired CHD with prosthetic material or devices, placed surgically or by catheter, for the first 6 months after the procedure; and those with repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or device

CHD: Congenital heart disease; IE: Infective endocarditis.

Table 4 Models and specifications of gastroscopes available for pediatric use

Weight of the child (kg)	Model	Working length (cm)	Diameter (mm)		Manufacturer
			Outer	Inner
< 5, ultrathin gastroscope	Olympus GIF-XP190N	110	4.9	2	Olympus corporation
5-20, slim adult gastroscope	Olympus GIF-XP190N	110	5.4	2.2	Olympus corporation
	Fujifilm EG-580NW2	110	5.9	2.4	Fujifilm Endoscopy
> 20, adult-size gastroscope	Olympus GIF-H190	103	9.2	2.8	Olympus corporation
	Fujifilm EG-590WR	110	9.4	2.8	Fujifilm Endoscopy