Pediatric Endoscopy and High-risk Patients: A Clinical Report From the NASPGHAN Endoscopy Committee

Journal of Pediatric Gastroenterology and Nutrition
Jenifer R LightdaleNASPGHAN Endoscopy and Procedures Committee

Abstract

Pediatric gastrointestinal endoscopy has been established as safe and effective for diagnosis and management of many pediatric gastrointestinal diseases. Nevertheless, certain patient and procedure factors should be recognized that increase the risk of intra- and/or postprocedural adverse events (AEs). AEs associated with endoscopic procedures can broadly be categorized as involving sedation-related physiological changes, bleeding, perforation, and infection. Factors which may increase patient risk for such AEs include but are not limited to, cardiopulmonary diseases, anatomical airway or craniofacial abnormalities, compromised intestinal luminal wall integrity, coagulopathies, and compromised immune systems. Examples of high-risk patients include patients with congenital heart disease, craniofacial abnormalities, connective tissues diseases, inflammatory bowel disease, and children undergoing treatment for cancer. This clinical report is intended to help guide clinicians stratify patient risks and employ clinical practices that may minimize AEs during and after endoscopy. These include use of CO2 insufflation, endoscopic techniques for maneuvers such as biopsies, and endoscope loop-reduction to mitigate the risk of such compli...Continue Reading

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Citations

Jul 16, 2020·Clinical Endoscopy·Byung-Ho Choe
Jan 11, 2021·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Manabu TagawaYuji Mizokami
Aug 3, 2021·Frontiers in Pediatrics·Conrad B CoxGirish Hiremath
Aug 31, 2021·Frontiers in Pediatrics·Kayla T HartjesJenifer R Lightdale

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