Risks of endoscopy in hospitalized pediatric patients with collagen vascular diseases.
BACKGROUND
The gastrointestinal manifestations of the collagen vascular diseases have been well described in the pediatric population. These patients frequently have symptoms that constitute indications for endoscopy. However, the risks and benefits of endoscopy in this population have not been examined.


METHODS
A retrospective review of all patients with collagen vascular diseases hospitalized during a 7-year period was undertaken, and those patients who underwent endoscopy were identified.


RESULTS
Nine patients (5%) underwent endoscopic procedures (eight upper and three lower endoscopy). Complications and outcomes were analyzed. Indications for endoscopy included abdominal pain, gastrointestinal (GI) bleeding, and/or vomiting and diarrhea. Two patients had complications that required surgery within 1 day of the endoscopic procedure. One of these patients subsequently died with GI bleeding. Five of the nine patients had changes in their management after endoscopy. Helicobacter pylori infection was identified and treated in two patients. Three patients had esophagitis or gastritis and acid suppression treatment was started or optimized. Vasculopathy was present in the patients who had complications.


CONCLUSIONS
This series suggests that endoscopy can provide useful information for the management of the pediatric patient with GI symptoms and collagen vascular diseases. However, because serious and potentially life-threatening complications can occur, great care is needed in evaluating the risk/benefit ratio of endoscopy in these patients.
Weselman
B C
BC
Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Friedman
D B
DB
Warren
R W
RW
Soriano
H E
HE
D000293:Adolescent; D002648:Child; D003095:Collagen Diseases / Q000150:complications / Q000175:diagnosis*; D016292:Procedural Sedation; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects* / Q000379:methods; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014652:Vascular Diseases / Q000150:complications / Q000175:diagnosis*