Abstract

Objective: We aimed to focus descriptively and comparatively on the children with esophageal disorders requiring endoscopy: demographics, indications, methods, complications and outcomes.

Material and Methods: The records of the children with esophageal disorders indicative of endoscopy between January 2005 and February 2020 at the department of pediatric surgery of a tertiary health care center were reviewed in terms of demographic, etiological, technical aspects; including the comparison of flexible endoscopy (FE) and rigid endoscopy (RE).

Results: Endoscopy was indicated in a total of 242 children for foreign body ingestion (n=70, 28.9%), caustic ingestion (n=89, 36.8%), esophageal stricture (n=52, 21.5%) and other rare conditions (n=31, 12.8%). Fourty two of them did not undergo endoscopy, because their caregivers did not consent. Of the rest; 102 (42.1%) underwent RE, and 98 (40.5%) underwent FE. The mean age was 36.4±35.7 months. No statistically significant difference was detected between the mean ages of RE and FE groups (33.3±32.1 vs. 33.7±24.9 months, p=0.918). Most of the patients who underwent FE were significantly males (52% in FE group, 39.2% in RE group, p=0.046). Complication rate was 6.9% in RE group and no complication was detected in FE group (p=0.008). The difference of failure rates of the groups was statistically insignificant (3.9% in RE vs 0 in FE, p=0.066).

Conclusion: Both rigid and flexible endoscopy techniques are effective and safe for diagnostic or therapeutic esophageal interventions. Although each has its own advantages an disadvantages, performing rigid endoscopy takes a slightly but significantly higher risk of complication.

Keywords: Children, Endoscopy, Esophagus

References

  1. 1. Gmeiner D, von Rahden BH, Meco C, Hutter J, Oberascher G, Stein HJ. Flexible versus rigid endoscopy for treatment of foreign body impaction in the esophagus. Surg Endosc 2007;21(11):2026–2029. doi:10.1007/s00464-007-9252-6
  2. 2. Popel J, El-Hakim H, El-Matary W. Esophageal foreign body extraction in children: flexible versus rigid endoscopy. Surg Endosc 2011;25(3):919–922. doi:10.1007/s00464-010-1299-0
  3. 3. Hoffman RS, Burns MM, Gosselin S. Ingestion of Caustic Substances. N Engl J Med. 2020 Apr 30;382(18):1739-1748. doi: 10.1056/NEJMra1810769
  4. 4. Fallahi S, Hosseini SMV, Fallahi S, Salimi M, Hesam AA, Hoseini SH. Extent of injury of gastrointestinal tract due to accidental ingestion of chemicals among children at Bandar Abbass Children Hospital 2009-2011. Life Sci J. 2012;9(4):2054-2058.
  5. 5. Temiz A, Oguzkurt P, Ezer SS, Ince E, Hicsonmez A. Long-term management of corrosive esophageal stricture with balloon dilation in children. Surg Endosc Other Interv Tech. 2010;24(9): 2287-2292. doi:10.1007/s00464-010-0953-x.
  6. 6. Bicakci U, Tander B, Deveci G, et al. Minimally invasive management of children with caustic ingestion: less pain for patients. Pediatr Surg Int. 2010; 26 (3): 251-255
  7. 7. Niedzielski A, Schwartz SG, Partycka-Pietrzyk K, Mielnik-Niedzielska G. Caustic Agents Ingestion in Children: A 51-Year Retrospective Cohort Study Ear Nose Throat J. 2020 Jan;99(1):52-57. doi: 10.1177/0145561319843109.
  8. 8. Barrón Balderas A, Robledo Aceves M, Coello Ramírez P, García Rodríguez E, Barriga Marín JA. Endoscopic findings of the digestive tract secondary to caustic ingestion in children seen at the Emergency Department. Arch Argent Pediatr. 2018 Dec 1;116(6):409-414. doi: 10.5546/aap.2018.eng.409.
  9. 9. Kramer RE, Lerner DG, Lin T, Manfredi M, Shah M, Stephen TC et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN endoscopy committee. J Pediatr Gastroenterol Nutr 2015;60(4):562–74.
  10. 10. Eisen GM, Baron TH, Dominitz JA, Faigel DO, Goldstein JL, Johanson JF,et al. Guideline for the management of ingested foreign bodies. Gastrointest Endosc 2002; 55(7):802–806
  11. 11. Russell RT, Cohen M, Billmire DF. Tracheoesophageal fistula following button battery ingestion: successful non-operative management. J Pediatr Surg 2013; 48(2):441–444. doi:10.1016/j. jpedsurg.2012.11.040
  12. 12. Litovitz T, Whitaker N, Clark L, White NC, Marsolek M. Emerging battery-ingestion hazard: clinical implications. Pediatrics 2010;125(6):1168–1177 doi:10.1542/peds.2009-3037
  13. 13. Tiryaki T, Akbıyık F, Şenel E, Mambet E, Livanelioğu Z, Atayurt H. Foreign Body Ingestion in Childhood. Turkish J. Pediatr. Dis. 2010; 4 (2): 94-99
  14. 14. Russell R, Lucas A, Johnson J, Yannam G, Griffin R, Beierle E,etr al. Extraction of esophageal foreign bodies in children: rigid versus flexible endoscopy Pediatr Surg Int 2014;30:417–422 doi:10.1007/s00383-014-3481-2
  15. 15. Sink JR, Kitsko DJ, Mehta DK, Georg MW, Simons JP. Diagnosis of Pediatric Foreign Body Ingestion: Clinical Presentation, Physical Examination, and Radiologic Findings. Ann Otol Rhinol Laryngol. 2016 Apr;125(4):342-50. doi: 10.1177/0003489415611128
  16. 16. Yan XE, Zhou LY, Lin SR, Wang Y, Wang YC. Therapeutic Effect of Esophageal Foreign Body Extraction Management: Flexible versus Rigid Endoscopy in 216 Adults of Beijing. Med Sci Monit. 2014 Oct 27;20:2054-60. doi: 10.12659/MSM.889758.
  17. 17. Ferrari D, Aiolfi A, Bonitta G, Riva CG, Rausa E, Siboni S, et al. Flexible versus rigid endoscopy in the management of esophageal foreign body impaction: systematic review and metaanalysis. World J Emerg Surg. 2018 Sep 12;13:42. doi: 10.1186/s13017-018-0203-4. eCollection 2018
  18. 18. ASGE Standards of Practice Committee, Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc 2011;73:1085-91 doi: 10.1016/j.gie.2010.11.010.
  19. 19. Wennervaldt K, Melchiors J. Risk of perforation using rigid oesophagoscopy in the distal part of oesophagus. Dan Med J. 2012; 59 (11): A4528
  20. 20. Gu Z, Wang Y, Lin K, Wang X, Cheng W, Wang L, et al.Magnetically Controlled Capsule Endoscopy in Children: A Single-center, Retrospective Cohort Study J Pediatr Gastroenterol Nutr. 2019 Jul;69(1):13-17. doi: 10.1097/MPG.0000000000002292.

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How to cite

1.
Güney LH, Fakıoğlu E, Acer Demir T. Upper Gastrointestinal Endoscopy in Pediatric Surgical Practice. Turk J Pediatr Dis [Internet]. 2022 Jan. 28 [cited 2025 May 25];16(1):65-9. Available from: https://turkjpediatrdis.org/article/view/921