ROLE OF GASTROINTESTINAL ENDOSCOPY IN CHILDREN

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  • 小児における内視鏡検査の役割

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Abstract

<p>Since there are few pediatric gastroenterologists in Japan, adult gastroenterologists may be consulted for pediatric gastrointestinal (GI) endoscopy in pediatric patients. This report provides an overview of the role of endoscopy in pediatric patients, which includes esophagogastroduodenoscopy (EGD), colonoscopy (CS), small bowel capsule endoscopy, and balloon-assisted enteroscopy in children. First, the indication of GI endoscopy in children and the equipment suitable for use in infants and toddlers are discussed. A key difference between pediatric and adult diagnostic procedures is that routine tissue sampling is performed in children from at least the duodenum, stomach, and esophagus during EGD and from the rectum, colon, and terminal ileum during CS with ileoscopy. Endoscopists must consider safety during bowel cleansing for CS in pediatric patients and should take into account the patientʼs willingness. Almost all GI procedures in children are performed under sedation or general anesthesia to ensure the patientsʼ safety, comfort, and cooperation. There are a number of physiologic differences between pediatric and adult patients that can alter the risks of complications during sedation, and special precautions are required before, during, and after sedation. Preparation for endoscopy in pediatric patients requires attention to physiologic issues as well as the emotional anxiety and psychosocial well-being of both the patients and their primary caregivers.</p>

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