COLONOSCOPY IN CHILDHOOD

  • 1 January 1984
    • journal article
    • research article
    • Vol. 73  (5) , 594-599
Abstract
A review was made of 139 fiberoptic colonoscopies performed between 1975-1982 on 113 patients aged 1 mo.-20 yr. General anesthesia was used in 4 procedures. All others were done under sedation with meperidine (mean dose 2.9 mg/kg) and diazepam (mean dose 0.5 mg/kg). Indications were rectal bleeding in 52 patients; assessment and surveillance of known inflammatory bowel disease in 33 patients; and diagnostic evaluation of abdominal pain, diarrhea and/or fever in 28 patients. The cecum was reached in 84% of diagnostic examinations. Comparison of findings on colonoscopy with Ba enema in 75 patients showed aggreement in 46, colonoscopic superiority in 25 and B enema superiority in 4. Bleeding sufficient to cause anemia was seen in 10/26 patients with polyps. Five minor complications and no major complications occurred. Flexible fiberoptic colonoscopy and polypectomy may be done usefully in childhood by physicians well versed and experienced with these procedures. Colonoscopy and biopsy changed the radiographic diagnosis from ulcerative colitis to Crohn''s disease in several cases and indicated greater extent of colonic disease in several cases of ulcerative colitis and Crohn''s disease. Colonoscopy is usually the most sensitive and accurate diagnostic tool for the evaluation of colonic disease, but Ba enema and colonoscopy are complementary tests and Ba enema should usually precede colonoscopy, with certain exceptions.