title: Therapeutic upper gastrointestinal endoscopy in children: an audit of 443 procedures and literature review.
abstract: The safety, effectiveness and capabilities of therapeutic upper fibreoptic endoscopy in children undergoing therapeutic endoscopic procedures (n = 443) was studied. Therapy for gastrointestinal bleeding formed the major group (injection sclerotherapy for varices, n = 197 procedures; thermocoagulation for haemorrhagic gastritis, n = 1; and photocoagulation for Dieulafoy's disease, n = 1). Sclerotherapy was 97% effective in controlling acute bleeding and 84% effective in obliterating varices with no serious complications or deaths. Oesophageal dilatations for surgical, caustic, congenital and peptic strictures and achalasia (n = 193) were performed with no oesophageal perforations or deaths. Foreign bodies were retrieved (n = 34) with no failures or complications. Percutaneous endoscopic gastrostomy was performed (n = 11) with one failure, proceeding to an unsuccessful surgical gastrostomy. Miscellaneous procedures included endoscopic transpyloric tube placement (n = 5) and endoscopic diathermy of pyloric web (n = 1). Therapeutic fibreoptic endoscopy is therefore concluded to be safe and effective in children, replacing rigid oesophagoscopy and some traditional surgical approaches.
authors.affiliation: Department of Gastroenterology and Nutrition, Royal Children's Hospital, Brisbane, Queensland, Australia.
authors.forename: A S
authors.initials: AS
authors.lastname: Goenka
authors.forename: M S
authors.initials: MS
authors.lastname: Dasilva
authors.forename: G J
authors.initials: GJ
authors.lastname: Cleghorn
authors.forename: M K
authors.initials: MK
authors.lastname: Patrick
authors.forename: R W
authors.initials: RW
authors.lastname: Shepherd
mesh_terms: D002675:Child, Preschool; D004106:Dilatation; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data; D004940:Esophageal Stenosis / Q000628:therapy; D004932:Esophageal and Gastric Varices / Q000628:therapy; D005260:Female; D005547:Foreign Bodies / Q000628:therapy; D006471:Gastrointestinal Hemorrhage / Q000628:therapy; D005774:Gastrostomy; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D008485:Medical Audit; D015911:Sclerotherapy