Pediatric Endoscopy and High-risk Patients: A Clinical Report From the NASPGHAN Endoscopy Committee

NASPGHAN Endoscopy and Procedures Committee

Research output: Contribution to journalArticle

Abstract

Pediatric gastrointestinal endoscopy has been established as safe and effective for diagnosis and management of many pediatric gastrointestinal diseases. Nevertheless, certain patient and procedure factors should be recognized that increase the risk of intra- and/or postprocedural adverse events (AEs). AEs associated with endoscopic procedures can broadly be categorized as involving sedation-related physiological changes, bleeding, perforation, and infection. Factors which may increase patient risk for such AEs include but are not limited to, cardiopulmonary diseases, anatomical airway or craniofacial abnormalities, compromised intestinal luminal wall integrity, coagulopathies, and compromised immune systems. Examples of high-risk patients include patients with congenital heart disease, craniofacial abnormalities, connective tissues diseases, inflammatory bowel disease, and children undergoing treatment for cancer. This clinical report is intended to help guide clinicians stratify patient risks and employ clinical practices that may minimize AEs during and after endoscopy. These include use of CO2 insufflation, endoscopic techniques for maneuvers such as biopsies, and endoscope loop-reduction to mitigate the risk of such complications such as bleeding and intestinal perforation. Endoscopic infection risk and guidance regarding periprocedural antibiotics are also discussed.

Original languageEnglish (US)
Pages (from-to)595-606
Number of pages12
JournalJournal of pediatric gastroenterology and nutrition
Volume68
Issue number4
DOIs
StatePublished - Apr 1 2019

Fingerprint

Endoscopy
Pediatrics
Craniofacial Abnormalities
Hemorrhage
Intestinal Perforation
Insufflation
Gastrointestinal Endoscopy
Connective Tissue Diseases
Gastrointestinal Diseases
Endoscopes
Infection
Inflammatory Bowel Diseases
Immune System
Heart Diseases
Anti-Bacterial Agents
Biopsy
Neoplasms

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

Cite this

Pediatric Endoscopy and High-risk Patients : A Clinical Report From the NASPGHAN Endoscopy Committee. / NASPGHAN Endoscopy and Procedures Committee.

In: Journal of pediatric gastroenterology and nutrition, Vol. 68, No. 4, 01.04.2019, p. 595-606.

Research output: Contribution to journalArticle

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