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Gastrointestinal Endoscopy and Mucosal Biopsy in the First Year of Life: Indications and Outcome
Journal of Pediatric Gastroenterology and Nutrition, 06/15/2012
Volonaki E et al. – In two–thirds of cases, histological abnormalities were detected that influenced management following endoscopic examination and mucosal biopsy in infants. Endoscopy with biopsies is a greatly informative test with low failure and complication rates in the first year of life.
Methods- All of the children younger than 1 year referred to a single tertiary paediatric gastroenterology unit during the period June 1987 to August 2007 who underwent gastrointestinal endoscopy were identified and the clinical indications and histological outcomes were reviewed.
- A total of 933 gastroesophageal duodenoscopies and 439 colonoscopies were performed in 1024 cases in a total of 823 infants.
- In order of frequency, clinical indications were diarrhoea (51%), failure to thrive (41.2%), symptoms of reflux (27.1%), and rectal bleeding (8.5%).
- Mucosal biopsies were insufficient for assessment in only 2.4% of cases.
- Mucosal histology was normal in 33.8%, whereas histological abnormalities were identified in 63.8%. Specific histological diagnoses included microvillous inclusion disease, autoimmune enteropathy, graft-versus-host disease post–bone marrow transplantation, tufting enteropathy, and disaccharidase deficiency.
- There was only 1 colonic perforation complicating endoscopy in a total of 889 cases for which relevant information was available (0.1%).