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Therapeutic upper gastrointestinal endoscopy in children: An audit of 443 procedures and literature review

Abstract The safety, effectiveness and capabilities of therapeutic upper fibreoptic endoscopy in children undergoing therapeutic endoscopic procedures (n= 443) was studied. Therapy for gastrointestinal bleeding formed the major group (injection sclerotherapy for varices, n= 197 procedures; thermocoagulation for haemorrhagic gastritis, n= 1; and photocoagulation for Dieulafoy's disease, n= 1). Sclerotherapy was 97% effective in controlling acute bleeding and 84% effective in obliterating varices with no serious complications or deaths. Oesophageal dilatations for surgical, caustic, congenital and peptic strictures and achalasia (n= 193) were performed with no oesophageal perforations or deaths. Foreign bodies were retrieved (n= 34) with no failures or complications. Percutaneous endoscopic gastrostomy was performed (n= 11) with one failure, proceeding to an unsuccessful surgical gastrostomy. Miscellaneous procedures included endoscopic transpyloric tube placement (n= 5) and endoscopic diathermy of pyloric web (n= 1). Therapeutic fibreoptic endoscopy is therefore concluded to be safe and effective in children, replacing rigid oesophagoscopy and some traditional surgical approaches.