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Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (5): 819-823. doi: 10.19723/j.issn.1671-167X.2019.05.005

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Pediatric colonoscopy findings and changing patterns from Beijing in one institutional experience over 12 years

Jun LI1,△(),Fang GU1,Zai-ling LI2,Yu-min LU1   

  1. 1. Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China
    2. Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China
  • Received:2018-10-29 Online:2019-10-18 Published:2019-10-23
  • Contact: Jun LI E-mail:yanwt2003@163.com

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Abstract:

Objective: To investigate the demographics and diagnostic yield in a cohort of Chinese pediatric patients undergoing colonoscopy in one institution over 12 years. Methouds: The study participants were consecutive patients aged <18 years that underwent their first colonoscopy in the endoscopy center at Peking University Third Hospital between Jan. 1, 2005 and Dec. 31, 2017. Demographic, endoscopic, and pathological findings were collected. According to the age of the patients, they were divided into 0-3 year-old group, 4-6 year-old group, 7-14 year-old group and 15-17 year-old group. The patients were also divided into 2005-2011 group and 2012-2017 group, according to the time of colonoscopy. Results: The cohort consisted of 326 patients, including 205 boys (62.9%) and 121 girls (37.1%). In the study, 31 patients (9.5%) were in 0-3 year-old group, 28 (8.6%) were in 4-6 year-old group, 96 (29.4%) were in 7-14 year-old group and 171 (52.5%) in 15-17 year-old group. The terminal ileum intubation success rate was 90.5% (295/326). No serious complications such as hemorrhage or perforation occurred during the procedures. The cleaning effect was good in 92.3% (301/326) of the patients. A total of 204 patients (62.6%) received a positive diagnosis under colonoscopy. 27.0% (88/326) of the patients was diagnosed as nonspecific colitis or terminal ileitis. 46 (14.1%) with inflammatory bowel disease (IBD) and 39 (12.0%) with polyp. The diseases were significantly different among the different age groups. The highest IBD diagnostic rate was found in 0-3 year-old group (7/31, 22.5%), while the highest polyp finding rate was in 4-6 year-old group (8/28, 28.6%). The number of the patients in 0-3 year-old group was significantly increasing in 2012-2017 group compared with 2005-2011 group (27/191 vs. 4/135, P=0.001), while the terminal ileum intubation success rate was higher (179/191 vs. 116/135, P=0.037). However, comparisons between years 2005-2011 and 2012-2017 showed that neither IBD nor polyp detection rate changed significantly (P=0.850). Conclusion: Colonoscopy in pediatric patients was a safe and effective procedure. Colitis or terminal ileitis was the primary finding during colonoscopy while IBD was the second one, and polyp was the third. However, the diagnostic yield did not change significantly. IBD was not as quickly increased in our hospital as it was in South China.

Key words: Child, Colonoscopy, Diagnosis, Gastrointestinal diseases

CLC Number: 

  • R574

Table 1

Demographic data of the patients undergoing colonoscopyn(%)"

Items Total 0-3 4-6 7-14 15-18 P
Cases 326 31 (9.5) 28 (8.6) 96 (29.4) 171 (52.5) -
Numbers 385 36 (9.4) 32 (8.3) 112 (29.1) 205 (53.2) -
Gender 0.905
Male 205 20 (64.5) 17 (60.7) 63 (65.6) 105 (61.4)
Female 121 11 (35.5) 11 (39.3) 33 (34.4) 66 (38.6)
Depth (the 1st colonoscopy, n=440) 0.368
Terminal ileum 295 30 (96.8) 26 (92.9) 85 (88.5) 154 (90.0)
Cecum 14 0 0 6 (6.3) 8 (4.7)
Colon 17 1 (3.2) 2 (7.1) 5 (5.2) 9 (5.3)
Cleaning effect 0.187
Good 222 26 (83.9) 21 (75.0) 64 (66.7) 111 (64.9)
Fair 79 4 (12.9) 4 (14.3) 22 (22.9) 49 (28.7)
Poor 25 1 (3.2) 3 (10.7) 10 (10.4) 11 (6.4)

Table 2

Diagnostic yields of pediatric colonoscopyn(%)"

Items Total
(n=326)		 0-3
(n=31)		 4-6
(n=28)		 7-14
(n=96)		 15-18
(n=171)		 P
Negative 122 (37.4) 5 (16.1) 6 (21.4) 31 (32.3) 80 (46.8) 0.001
Nonspecific colitis or terminal ileitis 88 (27.0) 11 (35.5) 6 (21.4) 34 (35.4) 37 (21.6) 0.060
IBD 46 (14.1) 7 (22.5) 3 (10.7) 14 (14.6) 22 (12.9) 0.546
UC 11 0 0 6 (6.3) 5 (2.9)
CD 12 2 (6.4) 1 (3.6) 0 9 (5.3)
un-determined 23 5 (16.1) 2 (7.1) 8 (8.3) 8 (4.6)
TB 5 (1.5) 0 0 2 (2.1) 3 (1.8) -
Polyp 39 (12.0) 6 (19.4) 8 (28.6) 10 (10.4) 15 (8.8) 0.030
FAP 8 1 (3.2) 0 3 (3.1) 4 (2.3)
Juvenile polyp 6 1 (3.2) 0 3 (3.1) 2 (1.2)
Allergic purpura 10 (3.1) 0 3 (10.7) 1 (1.0) 6 (3.5) -
Vascular malformation 4 (1.2) 1 (3.2) 1 (3.6) 1 (1.0) 1 (0.6) -
Diverticulum 2 (0.6) 0 0 1 (1.0) 1 (0.6) -
Others 10 (3.1) 1 (3.2) 1 (3.6) 2 (2.1) 6 (3.5) -

Table 3

Demographic data of the patients undergoing colonoscopy alone with time"

Items 2005-2011 2012-2017 P
Cases 135 191
Average age/years 13.6±4.0 11.7±5.6 0.001
Age, n(%) 0.001
0-3 4 (3.0) 27 (14.1)
4-6 8 (5.9) 20 (10.5)
7-14 45 (33.3) 51 (26.7)
15-17 78 (57.8) 93 (48.7)
Gender, n(%) 0.235
Male 90 (66.7) 115 (60.2)
Female 45 (33.3) 76 (39.8)
Depth (the 1st colonoscopy), n(%) 0.037
Terminal ileum 116 (85.9) 179 (93.7)
Cecum 10 (7.4) 4 (2.1)
Colon 9 (6.7) 8 (4.2)
Cleaning effect, n(%) 0.335
Good 96 (71.1) 126 (66.0)
Fair 32 (23.7) 47 (24.6)
Poor 7 (5.2) 18 (9.4)

Table 4

Diagnostic yields of pediatric colonoscopy alone with timen(%)"

Items 2005-2011
(n=135)		 2012-2017
(n=191)
Negative 49 (36.3) 73 (38.2)
Nonspecific colitis or terminal ileitis 39 (28.9) 49 (25.7)
IBD 23 (17.0) 23 (12.0)
UC 5 (3.7) 6 (3.1)
CD 8 (5.9) 4 (2.1)
TB 2 (1.5) 3 (1.6)
Polyp 14 (10.4) 25 (13.1)
FAP 3 (2.2) 5 (2.6)
Juvenile polyp 2 (1.5) 4 (2.1)
Allergic purpura 4 (3.0) 6 (3.1)
Vascular malformation 1 (0.7) 3 (1.6)
Diverticulum 1 (0.7) 1 (0.5)
Others 2 (1.5) 8 (4.2)
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