Colonoscopy in children

ABSTRACT

To study the safety and diagnostic yield of colonoscopy in children and see the pathological pattern in those who underwent biopsy of the lesion. Retrospective analysis was carried out on paediatric colonoscopies that were carried out at Military Hospital, Rawalpindi over 5 years. All children presenting with lower gastro intestinal bleeding, chronic diarrhea and abdominal pain were subjected to colonoscopic examination. The procedure was done after 72 hours preparation, under Ketamine sedation. Mucosal biopsies were taken where indicated and polypectomies were performed using snare and electrocautery. A total of 190 children [111 boys, 79 girls; mean age 5.7 +/- 3.5 years] were included in the study. A diagnosis could be made in 162 [85.2%] patients which included polyps [138], colitis [18] and miscellaneous causes [6]. On histology, colitis was further defined into nonspecific colitis in 15 cases with 6 showing features suggestive of ulcerative colitis. Eosinophilic colitis was seen in 3 cases. Majority [78%] of polyps were in the rectosigmoid colon and all were juvenile hamartomatous polyps except two which were adenomatous polyps. Mean age for children with colitis and polyps were 6.5 and 5.1 years respectively. There was no procedure-related complication. Rectal bleeding was the major indication for colonoscopy and majority of the cases had polyps. Colonoscopy is a safe procedure in children and can be carried out under conscious sedation. All patients with rectal bleeds should undergo colonoscopy and this instruments should be available in all tertiary care pediatric units