OAK BROOK, Ill -- November 26, 2009 -- In the November issue of GIE: Gastrointestinal Endoscopy, a study examining endoscopic ultrasound (EUS) found that EUS and EUS-fine needle aspiration (FNA) is feasible and safe in paediatric patients, and may have a significant impact on paediatric gastrointestinal (GI), pancreatobiliary, and mediastinal diseases.
Although the role of EUS is well established in adult GI and pacreatobiliary disease, knowledge of EUS in children is limited. This is because of the relatively low incidence of pancreatobiliary and GI neoplasias, presumptive limitations in the size of EUS equipment and accessories, the need for general anaesthesia, and the lack of highly trained and experienced endosonographers in paediatric patients.
With the refinement of techniques and advances in endosonographic design, several case reports and studies found successful use of EUS in paediatric patients.
The aim of the current retrospective study was to describe clinical and demographic characteristics, indications, feasibility, safety, and impact of EUS in the paediatric patient population from 2 university hospitals.
All EUS procedures performed from September 2001 to September 2008 at the Oregon Health & Science University, Portland, Oregon, and the University of Utah School of Medicine, Salt Lake City, Utah were reviewed. Patients aged younger than 18 years were identified.
All EUS procedures were performed by experienced endosonographers who independently performed more than 1,000 EUS procedures in adults. All procedures were performed in facilities specialised in the care of adult patients.
Over the 7-year period, 40 of 6,724 EUS procedures were performed on 38 patients aged younger than 18 years. The procedure was successful in all patients and no complications related to sedation, EUS or EUS-FNA were encountered.
The study also found that standard adult EUS equipment and accessories could be used in all patients to successfully perform procedures in children aged 3 years or older.
Disorders of the pancreatobiliary system were the primary indication in the majority of the study cases (62.5%), which is in keeping with previous studies.
EUS allows the physician to avoid having to perform more invasive and higher risk procedures such as endoscopic retrograde cholangiopancreatography, laparoscopy, and mediastinoscopy.
Although standard-size instruments may be used even in younger children, the need for deeper levels of sedation and maintenance of a patent airway will frequently require the assistance of anaesthesia services.
SOURCE: American Society for Gastrointestinal Endoscopy
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