Jaramillo Catalina, Ermarth Anna K, Collier John S, Pohl John F, Patel Raza A
Pediatric Gastroenterology, University of Utah Health, Salt Lake City, USA.
Cureus. 2023 May 4;15(5):e38553. doi: 10.7759/cureus.38553. eCollection 2023 May.
Although flexible sigmoidoscopy (FS) is utilized in children for the diagnosis of pediatric gastrointestinal conditions, such as inflammatory bowel disease and juvenile polyp disorders, the diagnostic yield of FS in pediatric patients is unknown.
We retrospectively reviewed FS cases in children under 18 years of age over a five-year period at our institution. Indications for the procedure, endoscopic visual findings, histologic findings, final diagnosis, and any management changes based on FS findings were included.
A total of 354 cases were included in the analysis for which 40 cases (11.3%) had abnormal visual findings, 48 cases (13.6%) had abnormal histologic findings, and 13 cases (3.7%) had both abnormal endoscopic visual and histologic findings. Of the 88 cases with abnormal visual and/or histologic abnormalities, only the results of 34 of these FS cases led to a change in management based on endoscopic findings (9.6%). Most patients with a non-diagnostic FS had a final diagnosis of functional abdominal pain; most patients with a diagnostic FS had a final diagnosis of colitis, not otherwise specified.
Our findings suggest that FS is not a helpful diagnostic endoscopic intervention in pediatric patients, especially in children with reassuring history and physical exam findings.
尽管柔性乙状结肠镜检查（FS）在儿童中用于诊断小儿胃肠道疾病，如炎症性肠病和幼年息肉病，但FS在儿科患者中的诊断率尚不清楚。
我们回顾性分析了本机构5年内18岁以下儿童的FS病例。纳入了该检查的适应证、内镜视觉检查结果、组织学检查结果、最终诊断以及基于FS检查结果的任何管理变化。
共有354例病例纳入分析，其中40例（11.3%）有异常视觉检查结果，48例（13.6%）有异常组织学检查结果，13例（3.7%）内镜视觉检查和组织学检查结果均异常。在88例有异常视觉和/或组织学异常的病例中，只有34例FS病例的结果基于内镜检查结果导致了管理上的改变（9.6%）。大多数FS检查无诊断意义的患者最终诊断为功能性腹痛；大多数FS检查有诊断意义的患者最终诊断为未另作说明的结肠炎。
我们的研究结果表明，FS对儿科患者不是一种有用的诊断性内镜干预措施，尤其是对于病史和体格检查结果令人放心的儿童。
