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Группа авторов. Practical Pediatric Gastrointestinal Endoscopy
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Practical Pediatric Gastrointestinal Endoscopy
Personal statements
Contributors
About the Companion Website
1 Introduction
2 History of pediatric gastrointestinal endoscopy
KEY POINTS
The precursors
The fiberscope
Training
Evolution
Conclusion
REFERENCES
3 The endoscopy unit
KEY POINTS
Unit design
Unit management
Equipment
Conclusion
REFERENCES
4 Pediatric procedural sedation and general anesthesia for gastrointestinal endoscopy
KEY POINTS
Introduction
Definitions/spectrum of sedation to general anesthesia
Box 4.1 ASA physical status classification
Assessing risk in the pediatric patient
Predictors of adverse events for GI procedures
Obesity
NPO
Upper respiratory infection
Preparation
Staffing and environment preparation
During sedation and monitoring
End‐tidal capnography
Postsedation care
Conclusion
FURTHER READING
5 Pediatric endoscopy training and ongoing assessment
KEY POINTS
Introduction
Training
Endoscopy skill acquisition
Endoscopy training aids
Training the pediatric endoscopy trainer
Assessment
Assessment based on quality metrics
Direct observational assessment tools
Conclusion
REFERENCES
6 Recertification and revalidation as concepts in pediatric endoscopy
KEY POINTS
REFERENCES
7 The role of the Global Rating Scale in pediatric endoscopy
KEY POINTS
Introduction
Pediatric endoscopy GRS
The future
REFERENCES
FURTHER READING
8 Quality indicators as a critical part of pediatric endoscopy provision
KEY POINTS
Introduction
Conclusion
REFERENCES
9 e‐learning in pediatric endoscopy
KEY POINTS
USEFUL WEBSITES
10 Indications for gastrointestinal endoscopy in childhood
KEY POINTS
Introduction
Diagnostic endoscopy
Therapeutic indications for endoscopy
11 Diagnostic upper gastrointestinal endoscopy
KEY POINTS
Introduction
Indications for EGD
Assembling the equipment and preprocedure check‐up
Endoscope handling
Preparation for esophageal intubation
Techniques of esophageal intubation
Exploration of the esophagus, stomach, and duodenum
Biopsy technique
pH and pH impedance probe placement
Complications
Uncommon, incidental, and rare findings during EGD. Esophageal squamous papilloma (ESP)
Esophageal adenocarcinoma (EAC)
Collagenous gastritis
Late sequelae of severe acid‐induced corrosive gastritis
Pyloric duplication cyst
Heterotopic pancreas
Gastric polyps
Gastric malignancy
Peptic ulcer disease
Intestinal lymphangiectasia
FURTHER READING
12 Pediatric ileocolonoscopy
KEY POINTS
Bowel preparation for colonoscopy
Indications for ileocolonoscopy
Contraindications for ileocolonoscopy
Equipment
Informed consent and preprocedure preparation
Specifics of sedation for colonoscopy
Embryology of the colon relative to ileocolonoscopy
Endoscopic anatomy of the colon and terminal ileum
Torque steering technique – the key to successful ileocolonoscopy
Golden rules of ileocolonoscopy
Technique of ileocolonoscopy. Handling the colonoscope
Getting started and patient positioning
Rectal intubation
Endoscopic clues to a hidden lumen
Exploration of the sigmoid colon and sigmoid–descending junction
Descending colon
Splenic flexure and transverse colon
Hepatic flexure, ascending colon, and cecum
Terminal ileum intubation
Withdrawing
Complications
Common pathology: rectal bleeding. Inflammatory bowel disease
Allergic proctocolitis
Pseudopolyps, juvenile polyps, and polyposis syndromes
Rare pathology. Polyposis syndromes
Peutz–Jeghers syndrome
Familial adenomatous polyposis
Colon cancer
Adenocarcinoma of the colon in ulcerative colitis
Non‐Hodgkin’s lymphoma of the terminal ileum
Isolated Langerhans cell histiocytosis of the colon
Vascular malformation of the colon
FURTHER READING
13 Handling of specimens and orientation of biopsies
KEY POINTS
Introduction
Specimen handling in the endoscopy unit
Specimen handling in the histopathology laboratory
Macroscopic description
Processing, embedding, and microtomy
REFERENCES
14 Enteroscopy
KEY POINTS
Introduction
Double‐balloon enteroscopy technique
Indications for DBE
Pediatric experience
Complications
Training issues and learning curve
Single‐balloon enteroscopy
Spiral enteroscopy
Intraoperative or laparoscopy‐assisted enteroscopy
General complications
Conclusion
FURTHER READING
15 Wireless capsule endoscopy
KEY POINTS
Introduction
Practical approach
Pediatric experience and pathologies. Small bowel IBD and inflammatory pathologies
Polyposis syndromes and other intestinal tumors
Occult or obscure intestinal bleeding
Other indications
Recent developments
Conclusion
REFERENCES
16 Endoscopic ultrasonography
KEY POINTS
Introduction
Instruments and technique
Ultrasound catheter probe (radial EUS)
Front‐loading ultrasound probe
Radial endoscopic ultrasonography
Balloon contact method
Water‐filling method
Balloon contact plus water‐filling method
Linear endoscopic ultrasonography
Appearance of the gastrointestinal wall on EUS images
Indications in children
EUS features in pediatric diseases. Esophageal strictures
Stomach
Pancreatobiliary ducts
REFERENCES
17 Chromoendoscopy
KEY POINTS
Indications. Esophageal disorders
Helicobacter pylori infection and related disorders
Celiac disease
Polyposis syndromes
Inflammatory bowel disease
Other indications
Application technique. Equipment
Methylene blue
Lugol’s solution
Toluidine blue
Indigo carmine
Congo red
Phenol red
Acetic acid
India ink
Patient sedation
Preparation of the mucosa
Staining technique
Recognition of lesions. Barrett’s esophagus and related disorders
Helicobacter pylori infection and related disorders
Celiac disease
Polyposis syndromes
Inflammatory bowel disease
FURTHER READING
18 Confocal laser endomicroscopy in the diagnosis of pediatric gastrointestinal disorders
KEY POINTS
Contrast agents
Upper GI tract
Lower GI tract
Conclusion
FURTHER READING
19 High‐risk pediatric endoscopy
KEY POINTS
Introduction
Patients at high risk for cardiopulmonary and sedation‐related events
Patients at high risk for bleeding
Patients at high risk for perforation
Patients at high risk for endoscopy‐related infections
Exogenous infection transmission
Patient risk factors for endogenous infection transmission
Risk factors for procedure‐related infections
REFERENCES
20 Esophagitis
KEY POINTS
Introduction
Infectious esophagitis
Esophagitis associated with HIV
Esophagitis caused by Candida
Esophagitis caused by CMV
Esophagitis caused by HSV
Esophagitis caused by tuberculosis
Other esophageal infections
Epidermolysis bullosa
Esophagitis in Crohn's disease
Chemotherapy and radiotherapy‐induced esophagitis
Final considerations
REFERENCES
21 Eosinophilic esophagitis
KEY POINTS
Introduction
Mucosal biopsy procurement
Assessment of esophageal gross findings
Therapeutic uses for endoscopy
Future alternative devices for mucosal assessment
Acknowledgments
REFERENCES
22 Gastritis and gastropathy
KEY POINTS
Introduction
Infective gastropathy
Reactive gastropathy
Conclusion
REFERENCES
23 Celiac disease
KEY POINTS
Introduction
Visual diagnosis, biopsy sampling, handling, and histopathology
Future of endoscopy in pediatric CD
REFERENCES
24 Role of endoscopy in inflammatory bowel disease including scoring systems
KEY POINTS
Introduction
Diagnosis
Monitoring
Scoring systems. Ulcerative colitis
Mayo score
Ulcerative Colitis Endoscopic Index of Severity (UCEIS)
Ulcerative Colitis Colonoscopic Index of Severity (UCCIS)
Crohn’s disease. Crohn’s Disease Endoscopic Index of Severity (CDEIS)
Simple Endoscopic Score for CD (SES‐CD)
Rutgeerts score
REFERENCES
25 Endoscopic management of esophageal strictures
KEY POINTS
Stricture presentation
Classification
Diagnosis
Differential diagnosis
Treatment. Bougie dilation
Balloon dilation
Adjunct therapies. Intralesional steroid injection
Mitomycin C
Incisional therapy
Esophageal stenting
Self‐expandable metal stents
Self‐expandable plastic stents
Biodegradable stents
Dynamic Stent
Outcome
REFERENCES
26 Endoscopic management of caustic ingestion
KEY POINTS
Introduction
Epidemiology
Pathophysiology
Clinical presentation
Assessment and management
Endoscopy
Treatment
Long‐term complications
REFERENCES
27 Pneumatic balloon dilation and peroral endoscopic myotomy for achalasia
KEY POINTS
Introduction
Diagnosis and management of achalasia
Therapeutic options
Pneumatic balloon dilation
Peroral endoscopic myotomy
REFERENCES
28 Endoscopic approaches to the treatment of gastroesophageal reflux disease
KEY POINTS
Introduction
Endoscopic suturing devices
EsophyX ®
Delivery of radiofrequency energy (Stretta® system)
Gastroesophageal biopolymer injection
Conclusion
FURTHER READING
29 Foreign body ingestion
KEY POINTS
Introduction
Diagnostic evaluation
Esophageal impaction of a foreign body
Foreign bodies in the stomach and small bowel
Batteries
Magnets
Drug packets
Food bolus impaction
Equipment and management approaches for foreign body removal
REFERENCES
30 Non‐variceal endoscopic hemostasis
KEY POINTS
Introduction
General considerations
Choice of endoscope
Techniques of endoscopic hemostasis
Epinephrine injection therapy
Endoscopic hemostatic powder and gel
Hemostatic clips
Over‐the‐scope clip
Thermal coagulation
Bipolar or multipolar thermal devices
Computer‐controlled thermal probes (heater probes)
Argon plasma coagulation (APC)
Technique of thermal coagulation
REFERENCES
31 Variceal endoscopic hemostasis
KEY POINTS
Portal hypertension and variceal formation
Diagnosis, classification, and risk stratification of varices
Primary prophylaxis
Acute bleeding
Hemospray®
Self‐expanding metal stents
Secondary prophylaxis
Gastric varices
REFERENCES
32 Endoscopic approach to obscure gastrointestinal bleeding lesions
KEY POINTS
Introduction
Classification
Evaluation and management of obscure gastrointestinal bleeding
Capsule endoscopy (CE)
Diagnostic and therapeutic approach with enteroscopy. Double‐balloon enteroscopy
Push enteroscopy
Intraoperative enteroscopy
Bleeding scans and other modalities
Conclusion
REFERENCES
33 Percutaneous endoscopic gastrostomy
KEY POINTS
Introduction
Indications
Contraindications
Decision to proceed with PEG and preprocedure evaluation
Technique. Personnel
Patient preparation
PEG insertion procedure
Postprocedure management
Complications
New uses of the PEG technique
Conclusion
FURTHER READING
34 Single‐stage percutaneous endoscopic gastrostomy
KEY POINTS
Introduction
Indications
Contraindications
Advantages of single‐stage PEG
Drawbacks
Technique. Personnel
Procedure. 1. Site identification
2. Marking the site
3. Placing of gastropexy
4. Creating the stoma tract
5. Dilation of the stoma tract and measuring the stoma length
6. Button placement
Postprocedure management
Complications
Useful tips
Materials
Consent
REFERENCES
35 Pediatric laparoscopic‐assisted direct percutaneous jejunostomy
KEY POINTS
Introduction
Conclusion
FURTHER READING
36 Naso‐jejunal and Gastro‐jejunal tube placement
KEY POINTS
FURTHER READING
37 Endoscopic retrograde cholangiopancreatography
KEY POINTS
Introduction
Duodenoscopes and accessories
Performing ERCP in children
Adverse events in pediatric ERCP
Biliary indications for diagnostic and therapeutic ERCP
Biliary atresia
Choledochal cysts
Choledocholithiasis
Primary sclerosing cholangitis
Postsurgical and posttraumatic biliary disease
Pancreatic indications for diagnostic and therapeutic ERCP
Acute pancreatitis
Recurrent pancreatitis
Anomalous pancreaticobiliary union
Pancreas divisum
Functional biliary sphincter disorder (previously sphincter of Oddi dysfunction; SOD)
Chronic pancreatitis
Pancreatic pseudocyst, necrosis, and trauma
EUS in pancreatitis
Duodenal duplication cyst
Conclusion
FURTHER READING
38 Endoscopic drainage of pancreatic pseudocysts
KEY POINTS
Pancreatitis
Pancreatic pseudocysts
REFERENCES
39 Duodenal web division by endoscopy
KEY POINTS
FURTHER READING
40 Polypectomy
KEY POINTS
Principles of electrosurgery
Snare loops
Routine polypectomy
Safety routine
Preparation and techniques
Complications
FURTHER READING
41 Endomucosal resection
KEY POINTS
Introduction
High‐magnification chromoscopic colonoscopy
Pit patterns
HMCC in the detection of intraepithelial neoplasia and colitis‐associated cancer
Summary of limitations of current imaging technology
Endoscopic mucosal resection
Basic EMR technique
Postresection management
Complications of EMR
Clinical recommendations and conclusions
42 Endoscopic management of polyposis syndromes
KEY POINTS
Introduction and classification
Familial adenomatous polyposis
Juvenile polyposis syndrome
Peutz–Jeghers syndrome
43 Transnasal gastrointestinal endoscopy
KEY POINTS
Introduction
Preendoscopy preparation
Views and image quality
Duration
Success rates
Patient comfort and preference
Complications and safety profile
Therapeutic use
Future considerations
Conclusion
REFERENCES
44 Endoscopic bariatric approaches
KEY POINTS
Introduction
Intragastric balloons
Duodenojejunal bypass liner
Conclusion
FURTHER READING
45 Over‐the‐scope clip and full‐thickness resection device
KEY POINTS
FURTHER READING
46 Endoscopic treatment of gastrointestinal bezoars
KEY POINTS
REFERENCES
47 Natural orifice transendoluminal surgery
KEY POINTS
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