Complications of pediatric endoscopy.

In pediatric patients, UGI endoscopy and colonoscopy may provide essential information for diagnosis and management. Diagnostic endoscopic procedures generally are safe with a rate of less than 1% of serious complications. Therapeutic procedures carry higher rates of complications, but usually are also accomplished without problems. The rarity of complications creates a unique situation: many endoscopists encounter problems infrequently. Their personal experience is limited. When evaluating a patient for a potentially serious complication, the endoscopist struggles with maintaining objectivity and clear judgment. The responsible physician re-examines and re-evaluates the preceding events: Were risks explained clearly? Were correct decisions made during the procedure? Were early problems overlooked? Simultaneously, the physician endeavors to discern the seriousness of the patient's apparent problem and to design appropriate intervention. Dealing with these multiple issues may impair decision-making. In these trying situations, experienced colleagues and consultants can provide invaluable advice and counsel. Each physician must recognize situations in which soliciting help represents a critical initial step in the process of correcting or treating the complication. Optimal patient care results from review of the procedural details, assessment of the patient's current status, discussion of potential interventions, and evaluation of the effectiveness of interventions with trusted and experienced colleagues. The knowledge of who and when to call for support and guidance provides a final measure of insurance for minimizing the risk of procedure-related complications.