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• W2086766955 abstract "Background: Endoscopic Ultrasound (EUS) with or without fine needle aspiration (FNA) has a well established role in the evaluation of various gastrointestinal (GI) disorders in adults. The clinical utility and impact of EUS on the management of the pediatric population remains less clear. The aim of our study is to evaluate the feasibility, safety and impact of EUS in assessing gastrointestinal disorders in children. Methods: Using a prospectively maintained EUS database, all patients ≤18 years of age referred for EUS at Indiana University Medical Center between January 2000 and October 2008 were identified. EUS was performed by one of 6 expert endosonographers. Retrospective chart review was conducted to document procedure indications, type of anesthesia used, EUS findings, final FNA cytology results, and immediate complications. Results: 58 EUS procedures including 54 upper EUS (19 with FNA) and 4 lower EUS (one with FNA) were carried out on 56 patients (35 females). Median age was 17 years (range 4-18 years). EUS indications were: abdominal pain of suspected pancreatobiliary origin in 39 (70%), evaluation of upper GI mucosal/submucosal lesions in 8 (14%), evaluation of pancreatic abnormalities seen on prior imaging in 5 (9%), suspected perianal fistulas in 2 (4%), and rectal pain with unexplained bleeding in 2 (4%). The details of anesthesia used were available in 52 (90%) patients: 38 (73%) had nurse administered propofol sedation (NAPS) (median age 17), 9 (17%) had general anesthesia (median age 15), and 3 (6%) had fentanyl with meperidine (median age 16). Two patients required no sedation. Therapeutic interventions were performed in 5 patients: 4 celiac plexus blocks, and one EUS guided puncture of pancreatic duct for contrast injection during ERCP. Of the remaining 51 patients, EUS had an impact on patient's management in 44 (86%) including the new diagnosis of chronic pancreatitis in 20, duplication cysts in 3, pancreatic pseudocysts in 3, choledocholithiasis in 3, pancreas divisum in 2, solid pseudopapillary tumor of the pancreas in 2, aberrant vessels in 2, retroperitoneal hematoma/cysts in 2, carcinoid of the pancreas in 1, pancreatic rest in 1, gastric lipoma in 1, esophageal inflammatory polyp in 1, mediastinal lymphadenitis in 1, anorectal fistula in 1, and thrombosed hemorrhoids 1. EUS had no direct impact on patient management in 7 cases. The procedure was successfully completed in all patients with no reported immediate complications. Conclusion: EUS±FNA is feasible, safe, and had a significant impact on the management of most pediatric population referred for EUS at our institution. NAPS was safe and well tolerated in this group." @default.
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• W2086766955 date "2009-04-01" @default.
• W2086766955 modified "2023-10-17" @default.
• W2086766955 title "The Utility of Endoscopic Ultrasound for Evaluating Gastrointestinal Disorders in Pediatric Patients" @default.
• W2086766955 doi "https://doi.org/10.1016/j.gie.2009.03.053" @default.
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