Single balloon-assisted colonoscopy for placement of colonic manometry catheters: Initial experience in children

Objectives: Colonic manometry is used frequently in children with long standing and difficult to manage constipation to aid in management decisions. Accurate analysis requires placement of the colonic manometry catheter in the colon without looping. This is technically difficult due to the long-standing nature of the constipation in most patients leading to sigmoid and other colonic redundancy. Single balloon colonoscopy has been successfully used in adult in cases of difficult colonoscopy. We report the first series of single balloon-assisted colonoscopy for performing difficult colonoscopy in children and placing colonic manometry catheters. Methods: Retrospective chart review was performed to identify patients undergoing the procedure. All patients had prior preparation with nasogastric golytely. Results: Using the single balloon technique, 36 patients underwent placement of the colonic manometry catheter (ages ranging from3 to 16 years, weights 12 to 95 kg). Catheter placement was successful in all cases with procedure times of 20 to 105 minutes. No major complications were noted. Conclusions: This is the first reported series of using single balloon-assisted colonoscopy to perform difficult colonoscopy in children and place colonic manometry catheters. It may have other therapeutic implications in children such as removal of polyps or placement of similar catheters.