title: Endoscopic ultrasonography in pediatric patients--Experience from a tertiary care center in India.
abstract: OBJECTIVE
  Although endoscopic ultrasound (EUS) is used in the management of various gastrointestinal (GI) diseases in adults, data on its role in children is limited. This study evaluated the indications, safety, and impact of EUS in children.
  
  
  METHODS
  Records of children (<18 years age) who underwent EUS between January 2006 and September 2014 were reviewed retrospectively and analyzed.
  
  
  RESULTS
  One hundred and twenty-one children (70 males, 51 females) aged 15.2 ± 2.9 years (mean ± SD) underwent 123 diagnostic (including fine needle aspiration cytology (FNAC) in 7) and 2 therapeutic EUS procedures. Conscious sedation was used in 81 procedures (65%) and general anesthesia in 44 (35%). The pancreaticobiliary system was evaluated in 114 (118 procedures), mediastinum in 5, and stomach in 2 patients. EUS diagnosed chronic pancreatitis (21 patients), pancreatic necrosis (1), splenic artery pseudoaneurysm (1), gastric varix (1), pseudocysts (3), insulinomas (2), other pancreatic masses (2), choledocholithiasis (2), choledochal cysts (2), portal biliopathy (1), esophageal leiomyoma (1), gastric neuroendocrine tumor (NET) (1), and GI stromal tumor in stomach (1). EUS-guided FNAC was positive in four of seven patients (two had tuberculosis, one pancreatic solid pseudopapillary tumor, and one gastric NET). Three patients had minor adverse events. EUS had a positive clinical impact in 43 (35.5%) patients.
  
  
  CONCLUSIONS
  EUS is feasible and safe in children. It provides valuable information that helps in their clinical management.
authors.affiliation: Department of Gastroenterology, Christian Medical College, Vellore, 632 004, Tamil Nadu, India.
authors.forename: Ramit
authors.initials: R
authors.lastname: Mahajan
authors.affiliation: Department of Gastroenterology, Christian Medical College, Vellore, 632 004, Tamil Nadu, India. ebbysimon@gmail.com.
authors.forename: Ebby George
authors.initials: EG
authors.lastname: Simon
authors.affiliation: Department of Gastroenterology, Christian Medical College, Vellore, 632 004, Tamil Nadu, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Chacko
authors.affiliation: Department of Gastroenterology, Christian Medical College, Vellore, 632 004, Tamil Nadu, India.
authors.forename: D Viswanath
authors.initials: DV
authors.lastname: Reddy
authors.affiliation: Department of Gastroenterology, Christian Medical College, Vellore, 632 004, Tamil Nadu, India.
authors.forename: P Rupesh
authors.initials: PR
authors.lastname: Kalyan
authors.affiliation: Department of Gastroenterology, Christian Medical College, Vellore, 632 004, Tamil Nadu, India.
authors.forename: A J
authors.initials: AJ
authors.lastname: Joseph
authors.affiliation: Department of Gastroenterology, Christian Medical College, Vellore, 632 004, Tamil Nadu, India.
authors.forename: Amit Kumar
authors.initials: AK
authors.lastname: Dutta
authors.affiliation: Department of Gastroenterology, Christian Medical College, Vellore, 632 004, Tamil Nadu, India.
authors.forename: Sudipta Dhar
authors.initials: SD
authors.lastname: Chowdhury
authors.affiliation: Department of Gastroenterology, Christian Medical College, Vellore, 632 004, Tamil Nadu, India.
authors.forename: Reuben Thomas
authors.initials: RT
authors.lastname: Kurien
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004064:Digestive System / Q000000981:diagnostic imaging*; D004066:Digestive System Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D019160:Endosonography / Q000379:methods / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D010372:Pediatrics; D012189:Retrospective Studies; D062606:Tertiary Care Centers
keywords: Biliary tree; Diagnosis; Endosonography; Imaging; Pancreas; Pediatric