Therapeutic upper gastrointestinal tract endoscopy in Paediatric Gastroenterology

Table 1 A guide to use of paediatric scopes according to weight

Weight (kg)	OGD	ERCP
< 2.5	≤ 6 mm gastroscope	7.5 mm duodenoscope
2.5-10	≤ 6 mm gastroscope preferred. Standard gastroscopy may be considered particularly if endotherapy required	7.5 mm duodenoscope
10-35	Slim or Paediatric Gastroscope	Via slim or paediatric gastroscope
> 35	Standard	Most will tolerate standard therapeutic duodenoscope

Table 2 Current paediatric endoscopes available

Manufacturer	Model	Insertion tube length/diameter (mm)	Definition/magnification/colour enhancement	Biopsy channel diameter (mm)
Olympus	GIF-N180	1100/4.9	Standard/none/NBI	2.0
	GIF-XP180N	1100/5.5	Standard/none/NBI	2.0
Fujinon	EG530N	1100/5.9	High-definition/zoom/none	2.0
	EG530NP	1100/4.9	High-definition/zoom/none	2.0
Pentax	EG1690K	1100/5.4	Standard/zoom/iSCAN	2.0
	EG1870K	1050/6.0	Standard/zoom/iSCAN	2.0

Adapted table from ASGE equipment for paediatric endoscopy status evaluation report.

Table 3 Indications for upper gastrointestinal endoscopy

Diagnostic

Recurrent abdominal pain (differentiation from FGIDs is important)

Weight loss/failure to thrive not just due to lack of nutrition

Dysphagia

Diarrhoea/malabsorption (differentiation from FGIDs is important)

Continued vomiting/haematemesis other than a simple Mallory-Weiss tear

Investigation for iron deficiency anaemia

Suspected enteropathy-coeliac (new guidelines)/autoimmune

Part of investigations for inflammatory bowel disease

Therapeutic

Foreign body removal

Insertion of feeding tube

Dilation of strictures

Injection/banding varices

Treatment with Botox

Excision of polyps