P330 Diagnostic yield of lower gastro-intestinal endoscopy in tunisian children. (June 2019)

• Record Type: Journal Article
• Authors: Rabeh, Rania Ben; Othman, Asma Ben; Mrad, Sonia Mazigh; Brini, Ines; Boukthir, Samir
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 3
• Page Start: A289
• Page End: A290
• Publication Date: 2019-06
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-epa.679
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Introduction: Lower gastrointestinal endoscopy (LGIE) in children has diagnostic and therapeutic value. Pediatric LGIE is increasingly being used, but few studies have recently evaluated the diagnostic yield in children. This study aimed to investigate the indications and the diagnostic yield of diagnostic colonoscopy among Tunisian children. Methods: A retrospective study of children who underwent LGIE from January 2010 to December 2017, in a referral tertiary pediatric endoscopy center in Tunis was performed. Data on age, gender, indications, colonoscopic features and final diagnoses were collected and analyzed. The diagnostic yield of LGIE was defined as the percentage of patients in which the procedure showed endoscopic lesions. Results: Two hundred and ten children with 107 colonoscopies and 103 sigmoïdoscopies were enrolled. The rate of successful ileocecal approach was 9%. The diagnostic yield of colonoscopy was 83/210 (39%). The most common indication was lower gastrointestinal bleeding (LGIB) 120/210 (57.1%), followed by endoscopy performed for a diagnosis of suspected inflammatory bowel disease (IBD) 61/210 (29%). Out of the children who underwent colonoscopy, 39/210 (18.6%) were confirmed to have polyps, 20/210 (9.5%) to have IBD, 10/210 (4.7%) to have intestinal lymphoid nodular hyperplasia and 12/210 (5.7%) to have no specific colitis and two cases of colic tumors. The diagnostic yields of colonoscopy according to the major indications were 41.7% in LGIB and 45.9% in suspected IBD. There were no major procedure-related complications. LGIE contributed to the final diagnosis of gastrointestinal disorder in 102/210 (48.6%) by showing histological findings in favor of the diagnosis in biopsies or negative signs allowing to eliminate the diagnosis or by revealing abnormalities in proctologic examination. Conclusion: Rates of endoscopic and histological abnormalities from LGIE vary based on age and indication for endoscopy. The diagnostic yield of LGIE was moderate (39%). However, LGIE contributed to diagnosis and management of patients in about half of the cases (48.6%). Negative findings from LGIE can contribute in a positive way to the diagnosis and management of children with gastrointestinal symptoms. A study must be conducted to identify factors associated with diagnostic yield of LGIE in children.