title: Paediatric gastrointestinal endoscopy: a qualitative study.
abstract: OBJECTIVE
  Gastrointestinal endoscopy is an invasive procedure used to diagnose and/or treat diseases of the gut. As with any invasive procedure, there is a small risk for complications, and it is therefore important that due consideration be taken when reviewing the indications for endoscopy, particularly in children. Despite this, there remains a wide variation nationally in clinical practice among paediatric gastroenterologists. In the absence of a standard, we critically reviewed current endoscopy practice at Addenbrooke's Hospital with the aim of creating robust measures that could be used to achieve and maintain an efficient, high-quality paediatric endoscopy service. Specifically, we assessed the proportion of referred patients undergoing endoscopy and the clinical outcomes of these procedures.
  
  
  METHODS
  A retrospective list of new clinic patients who had undergone endoscopy within 3 months of their appointment was obtained, dating from 1 January 2011 to 31 December 2011. Individual electronic medical records (eMR) records were reviewed for the type of endoscopy, indications, interval to procedure, histology findings, diagnoses, and impact on management.
  
  
  RESULTS
  Out of the 674 children seen at clinic over the year, 17% (n=114) went on to have an endoscopic procedure; half of these patients underwent both upper endoscopy (i.e., oesophagogastroduodenoscopy) and colonoscopy. Out of the children who underwent colonoscopy, 43% (n=25) were confirmed to have inflammatory bowel disease.
  
  
  CONCLUSIONS
  Our results provide a useful initial reference point against which other tertiary units can assess their own practice, with all striving to provide appropriate, efficient and cost-effective endoscopy services for children.
authors.affiliation: aDepartment of Paediatric Gastroenterology, Childrens Hospital for Wales, Heath Park, Cardiff, Wales bDepartment of Paediatrics, Colchester Hospital University NHS Foundation Trust, Colchester General Hospital, Colchester, Essex cDepartment of Paediatric Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, UK.
authors.forename: Amar M
authors.initials: AM
authors.lastname: Wahid
authors.forename: Kalyaan
authors.initials: K
authors.lastname: Devarajan
authors.forename: Alexander
authors.initials: A
authors.lastname: Ross
authors.forename: Matthias
authors.initials: M
authors.lastname: Zilbauer
authors.forename: Robert
authors.initials: R
authors.lastname: Heuschkel
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D001323:Autoantibodies / Q000097:blood; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D003113:Colonoscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D003967:Diarrhea / Q000209:etiology; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000706:statistics & numerical data*; D019204:GTP-Binding Proteins / Q000276:immunology; D005762:Gastroenterology / Q000458:organization & administration; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000175:diagnosis*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis; D057045:Laryngopharyngeal Reflux / Q000209:etiology; D008485:Medical Audit; D009325:Nausea / Q000209:etiology; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012007:Rectum; D012189:Retrospective Studies; D013997:Time Factors; D011503:Transglutaminases / Q000276:immunology; D014839:Vomiting / Q000209:etiology
chemical_list: D001323:Autoantibodies; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins