Assessment of colonoscopic findings in pediatric patients; A single center experience

Year 2021, Volume: 14 Issue: 3, 475 - 483, 15.12.2021

Asuman Karhan Ferah Tuncel Yusuf Usta

https://doi.org/10.26559/mersinsbd.910627

Abstract

Aim: In this study, it was aimed to evaluate presenting symptoms, indications for colonoscopy, results and complications in pediatric patients undergoing colonoscopy. Method: Patients aged 0-18 years who underwent colonoscopy between January 2008 and December 2020 were included in the study. The demographic characteristics, colonoscopy and pathology results of the patients were analysed retrospectively. Results: The mean age of 489 patients was 12.39±4.32 years, 57.4% were male, 42.6% female. 408 patients had at least one symptom. The most common three symptoms are; rectal bleeding (n=265,54.1%), abdominal pain (n=187,38.2%) and bloody mucus in stool (n=112,22.9%). Main indications for colonoscopy were suspected inflammatory bowel disease (IBD) (n=212,43.3%), lower gastrointestinal bleeding (n=145,29.6%) and chronic diarrhea (n=59,12%). The two most common diagnoses were IBD (n=88,17.9%) and polyp (n=31,6.3%). Of those with IBD, 46(9.4%) had ulcerative colitis, 32(6.5%) had Crohn's disease and 11(2.2%) had undetermined IBD. Polyps were most frequently located (74.1%) in rectosigmoid colon, 61.2% of them were juvenile polyps. In 272 (55.6%) patients with normal results, the two most common symptoms were rectal bleeding (n=91,62.7%) and diarrhea (n=31,52.5%), the most common finding was anemia (n=25,59.5%). Colonoscopy results were normal in 30.6% of patients presenting with abdominal pain if there were with additional symptoms and 62.9% with no additional symptoms (p=0.032). Spontaneous perforation was observed in two patients (0.04%). Conclusion: Colonoscopy is a reliable method when performed with correct indication. Presence of additional symptoms should be investigated, especially in patients with abdominal pain. The most common disease in our study was IBD and it is predicted that its frequency will increase, but multicenter epidemiological studies are needed for more accurate results.

Keywords

Pediatrics, colonoscopy, gastrointestinal diseases

Pediatrik hastalarda kolonoskopi bulgularının değerlendirilmesi; Tek merkez deneyimi

Abstract

Amaç: Çalışmada, kolonoskopi yapılan çocuk hastalarda başvuru semptomları, işlem endikasyonları, sonuçlar ve komplikasyonların değerlendirilmesi amaçlandı. Yöntem: Çalışmaya Ocak 2008 ile Aralık 2020 tarihleri arasında kolonoskopi yapılan 0-18 yaş arası hastalar dahil edildi. Hastaların demografik özellikleri, kolonoskopi ve patoloji sonuçları geriye dönük incelendi. Bulgular: Çalışmaya dahil edilen 489 hastanın ortalama yaşı 12.39±4.32 yıl, %57.4’ü erkek, %42.6’sı kızdı. Hastaların 408’inde ≥1 semptom vardı. En sık üç semptom; rektal kanama (n=265, %54.1), karın ağrısı (n=187, %38.2) ve kanlı mukuslu dışkılamaydı (n=112, %22.9). Başlıca kolonoskopi endikasyonu inflamatuvar bağırsak hastalığı (İBH) şüphesi (n=212, %43.3), alt gastrointestinal sistemde kanama (n=145, %29.6) ve kronik ishaldi (n=59, %12). En sık iki tanı İBH (n=88, %17.9) ve polipti (n=31,%6.3). İnflamatuvar bağırsak hastalığı saptananların 46’sında (%9.4) ülseratif kolit, 32’sinde (%6.5) Crohn hastalığı ve 11’inde (%2.2) sınıflandırılamayan İBH olduğu belirlendi. Poliplerin en sık (%74.1) rektosigmoid kolonda yerleşim gösterdiği, %61.2’sinin juvenil polip olduğu saptandı. Sonuçları normal olan 272 (%55.6) hastada en sık iki semptomun rektal kanama (n=91, %62.7) ve ishal (n=31, %52.5), en sık bulgunun da anemi olduğu saptandı (n=25, %59.5). Karın ağrısıyla başvuran hastalarda, ek semptom varsa %30.6, ek semptom yoksa %62.9 oranında kolonoskopi sonucunun normal olduğu saptandı (p=0.032). İki hastada (%0.04) spontan perforasyon görüldü. Sonuç: Kolonoskopi doğru endikasyonla yapıldığında güvenilir bir yöntemidir. Özellikle karın ağrısıyla başvuran hastalarda, ek semptomların varlığı araştırılmalıdır. Çalışmamızda en sık saptanan hastalığın İBH olduğu ve sıklığın giderek artacağı öngörülmektedir ancak daha kesin sonuçlar için çok merkezli epidemiyolojik çalışmalara ihtiyaç vardır.

Keywords

Pediatri, kolonoskopi, gastrointestinal hastalıklar

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