Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2020; 12(10): 355-364
Published online Oct 16, 2020. doi: 10.4253/wjge.v12.i10.355
Role of endoscopic ultrasound in pediatric patients: A single tertiary center experience and review of the literature
Ahmed Youssef Altonbary, Hazem Hakim, Wagdi Elkashef
Ahmed Youssef Altonbary, Hazem Hakim, Department of Gastroenterology and Hepatology, Mansoura Specialized Medical Hospital, Mansoura University, Mansoura 35516, Egypt
Wagdi Elkashef, Department of Pathology, Mansoura University, Mansoura 35111, Egypt
Author contributions: Altonbary AY, Hakim H, Elkashef W contributed equally to this work; Altonbary AY contributed to the writing of the manuscript; Hakim H contributed to data collection and Elkashef W contributed to histopathological examination.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board at MedImmune and Gubra.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ahmed Youssef Altonbary, MD, Lecturer, Department of Gastroenterology and Hepatology, Mansoura Specialized Medical Hospital, Mansoura University, Mansoura 35516, Egypt. a.tonbary@gmail.com
Received: May 6, 2020
Peer-review started: May 6, 2020
First decision: May 15, 2020
Revised: May 18, 2020
Accepted: August 16, 2020
Article in press: August 16, 2020
Published online: October 16, 2020
Processing time: 161 Days and 3.9 Hours
Abstract
BACKGROUND

Although endoscopic ultrasound (EUS) is now widely available and has an established role in adults, the utility of EUS and EUS-guided fine needle aspiration (EUS-FNA) in pediatrics is insufficiently described compared to adults and is supported by only a few studies.

AIM

To report the experience of a single tertiary center in the use of EUS and EUS-FNA in a pediatric population and to further assess its safety, feasibility, and clinical impact on management.

METHODS

A retrospective study of 13 children (aged 18 years or younger) identified from our medical database was conducted. A retrospective review of demographic data, procedure indications, EUS findings, and the clinical impact of EUS on the subsequent management of these patients was performed.

RESULTS

During the 4-year study period, a total of 13 (1.7%) pediatric EUS examinations out of 749 EUS procedures were performed in our unit. The mean age of these 8 females and 5 males was 15.6 years (range: 6-18). Six of the 13 EUS examinations were pancreatobiliary (46.1%), followed by mediastinal 2/13 (15.4%), peri-gastric 2/13 (15.4%), abdominal lymphadenopathy 1/13 (7.7%), tracheal 1/13 (7.7%) and rectal 1/13 (7.7%). Overall, EUS-FNA was performed in 7 patients (53.8%) with a diagnostic yield of 100%. The EUS results had a significant impact on clinical care in 10/13 (77%) cases. No complications occurred in these patients during or after any of the procedures.

CONCLUSION

EUS and EUS-FNA in the pediatric population are safe, feasible, and have a significant clinical impact on the subsequent management; thus avoiding invasive and unnecessary procedures.

Keywords: Endoscopic ultrasound, Endoscopic ultrasound-guided fine needle aspiration, Pediatric

Core Tip: Although endoscopic ultrasound (EUS) is now widely available and has an established role in adults, the utility of EUS and EUS-guided fine needle aspiration in pediatrics is insufficiently described compared to adults and is supported by only a few studies. More effort is required to increase the awareness of EUS among pediatric gastroenterologists which may have a clinical impact on the subsequent management and minimize unnecessary procedures in children.