Safety and efficacy of endoscopic ultrasound as a diagnostic and therapeutic tool in pediatric patients: a multicenter study

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Ragab K.M.; El-Kassas M.; Madkour A.; Okasha H.H.; Agwa R.H.; Ghoneem E.A.

Journal: Therapeutic Advances in Gastrointestinal Endoscopy

Publisher: SAGE Publications Ltd

Publication Date: 15 November 2022

Volume / Issue: Volume 15

ISSN: 26317745

DOI: 10.1177/26317745221136767

Scopus: View on Scopus

Document Type: Article

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

Ragab K.M., Hepatology and Gastroenterology Department, Theodor Bilharz Research Institute, Cairo, Egypt; El-Kassas M., Endemic Medicine Department, Faculty of Medicine, Helwan University, Ain Helwan, Cairo, 11795, Egypt; Madkour A., Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt; Okasha H.H., Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt; Agwa R.H., Hepatology and Gastroenterology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Ghoneem E.A., Hepatology and Gastroenterology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Abstract

Background: Despite the well-established diagnostic and therapeutic applications of endoscopic ultrasound (EUS) in adults, data about its use in children are limited. In this study, we tried to assess the feasibility, safety, and clinical impact of EUS in pediatric patients. Methods: Data of pediatric patients (<18 years) referred for EUS over a 3-year period to the endoscopy units of four Egyptian tertiary centers were retrospectively analyzed. Significant impact was defined as a new diagnosis or treatment attributed to the EUS procedure. Results: Twenty-four diagnostic and five therapeutic EUS procedures were conducted in 29 children with a median age of 9 years. Indications for EUS included assessment of solid pancreatic mass (n = 3), pancreatic cyst (n = 2), suspected chronic pancreatitis (n = 9), pancreatic pseudocyst (PPC) (n = 5), recurrent hypoglycemia (n = 1), bile duct mass (n = 1), subepithelial lesion (esophageal, duodenal or anorectal) (n = 4), mediastinal mass (n = 1), pelvic mass (n = 3), and mass at splenic hilum (n = 1). Therapeutically, five patients underwent cystogastrostomy for symptomatic PPC with 100% technical and clinical success. EUS was able to diagnose 21 out of the other 24 patients. EUS-guided tissue acquisition was performed in 11 patients with definitive histopathological diagnosis in 10 patients (91%). There was no procedure-related major complication, while minor complications occurred in two cases (transient pain in one case, temporary fever, and vomiting in two cases). Conclusion: Standard linear EUS equipment and accessories can be used safely and effectively in selected pediatric patients for diagnostic and therapeutic purposes. © The Author(s) 2022.

Keywords

Egypt; endoscopic ultrasound; EUS; gastrointestinal disease; pediatric; safety; therapeutic; adolescent; anorectal disease; anorectal lesion; Article; bile duct tumor; child; chronic pancreatitis; clinical article; clinical outcome; diagnostic accuracy; diagnostic test accuracy study; duodenum injury; endoscopic ultrasonography; esophagus injury; feasibility study; female; fever; histopathology; human; human tissue; hypoglycemia; male; mediastinum tumor; pain; pancreas cyst; pancreas pseudocyst; pancreas tumor; patient referral; patient safety; pediatric patient; pelvis tumor; preschool child; retrospective study; school child; spleen tumor; therapy effect; ultrasound guided biopsy; vomiting

Citation Information

Scopus Citations: 15

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