CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(07): E969-E973
DOI: 10.1055/a-1178-9408
Original article

Urgent endoscopy in children: epidemiology in a large region of France

Lorenzo Norsa
1   Pediatric Gastroenterology, Hepatology and Nutrition, Necker Children’s Hospital, Paris, France
2   Pediatric Gastroenterology, Hepatology and Nutrition Ospedale Papa Giovanni XXIII, Bergamo, Italy
,
Alberto Ferrari
3   FROM Research Foundation, ASST Papa Giovanni XXIII, Bergamo, Italy
,
Alexis Mosca
4   Pediatric Gastroenterology and Nutrition, Universitary Robert-Debré hospital, Paris, France
,
Cecile Talbotec
1   Pediatric Gastroenterology, Hepatology and Nutrition, Necker Children’s Hospital, Paris, France
,
Florence Campeotto
1   Pediatric Gastroenterology, Hepatology and Nutrition, Necker Children’s Hospital, Paris, France
5   U1139 Pharmacology Department, Paris University, Paris, France
,
Julie Lemale
6   Pediatric Gastroenterology and Nutrition, Trousseau Hospital, Paris, France
,
Bénédicte Pigneur
1   Pediatric Gastroenterology, Hepatology and Nutrition, Necker Children’s Hospital, Paris, France
,
Jerome Viala
4   Pediatric Gastroenterology and Nutrition, Universitary Robert-Debré hospital, Paris, France
7   Paris Denis-Diderot Faculty. Paris, France
› Author Affiliations

Abstract

Background and study aims The real burden of urgent endoscopy in children has not been studied yet. Our aim was to evaluate the need for urgent endoscopy in children.

Patients and methods Information was collected about all the calls that were received during the 24 hour on-call shift for pediatric endoscopy in the region of Ile-de-France (12.1 million inhabitants) during a 6 months period (February-July 2017).

Results A total of 237 calls (19 calls/y/100,000 children) were collected regarding children of an average age of 3.2 years (range 2 days-18 years). Most of the calls (68 %) were for foreign body ingestions. Gastroscopy was required in 32 % of children: 24 % of those calling for foreign body ingestion, 48 % for gastrointestinal bleeding, 63 % for caustic ingestions (P = 0.01). The average time between the call and the urgent endoscopy were below the international recommendations for each situation.

Conclusions Calling the endoscopist seems to have become a recurrent practice, although in most cases, urgent endoscopy did not appear necessary, especially for foreign body ingestion. This organization of pediatric endoscopy on call was able to guarantee the performance of urgent endoscopy in adequate timing for a highly populated region.



Publication History

Received: 10 December 2019

Accepted: 16 April 2020

Article published online:
16 June 2020

© 2020. Owner and Copyright ©

© Georg Thieme Verlag KG
Stuttgart · New York

 
  • References

  • 1 Thomson M, Tringali A, Dumonceau J-M. et al. Paediatric Gastrointestinal Endoscopy: European Society for Paediatric Gastroenterology Hepatology and Nutrition and European Society of Gastrointestinal Endoscopy Guidelines. J Pediatr Gastroenterol Nutr 2017; 64: 133-153
  • 2 Henderson P, Hansen R, Russell R. et al. PTH-061 The management of acute upper gastrointestinal bleeding in paediatric practice: a national survey. Gut 2014; 63: A235.2-A236
  • 3 Thomson M. There is no excuse for mortality due to lack of competency and training of paediatric endoscopists in gastrointestinal bleeding therapy in 2018. J Pediatr Gastroenterol Nutr 2018; 67: 684-688
  • 4 Denney W, Ahmad N, Dillard B. et al. Children will eat the strangest things: a 10-year retrospective analysis of foreign body and caustic ingestions from a single academic center. Pediatr Emerg Care 2012; 28: 731-734
  • 5 Betalli P, Falchetti D, Giuliani S. et al. Caustic Ingestion Italian Study Group. Caustic ingestion in children: Is endoscopy always indicated? The results of an Italian multicenter observational study. Gastrointest Endosc 2008; 68: 434-439
  • 6 Banc-Husu AM, Ahmad NA, Chandrasekhara V. et al. Therapeutic endoscopy for the control of nonvariceal upper gastrointestinal bleeding in children: a case series. J Pediatr Gastroenterol Nutr 2017; 64: e88-e91
  • 7 Jayachandra S, Eslick GD. A systematic review of paediatric foreign body ingestion: presentation, complications, and management. Int J Pediatr Otorhinolaryngol 2013; 77: 311-317
  • 8 Muthiah KC, Enns R, Armstrong D. et al. A survey of the practice of after-hours and emergency endoscopy in Canada. Can J Gastroenterol J Can Gastroenterol 2012; 26: 871-876
  • 9 Population totale par sexe et âge au 1er janvier 2019, France − Bilan démographique 2018. Insee. https://www.insee.fr/fr/statistiques/1892086?sommaire=1912926
  • 10 Gummin DD, Mowry JB, Spyker DA. et al. 2016 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 34th Annual Report. Clin Toxicol Phila Pa 2017; 55: 1072-1252
  • 11 Litovitz T, Whitaker N, Clark L. et al. Emerging battery-ingestion hazard: clinical implications. Pediatrics 2010; 125: 1168-1177
  • 12 Lee JH. Foreign body ingestion in children. Clin Endosc 2018; 51: 129-136
  • 13 Orsagh-Yentis D, McAdams RJ, Roberts KJ. et al. Foreign-Body ingestions of young children treated in US emergency departments: 1995-2015. Pediatrics 2019; 143 DOI: 10.1542/peds.2018-1988.
  • 14 Al Lawati TT, Al Marhoobi R. Patterns and complications of ingested foreign bodies in Omani children. Oman Med J 2018; 33: 463-467
  • 15 Pant C, Olyaee M, Sferra TJ. et al. Emergency department visits for gastrointestinal bleeding in children: results from the Nationwide Emergency Department Sample 2006-2011. Curr Med Res Opin 2015; 31: 347-351
  • 16 Krom H, Visser M, Hulst JM. et al. Serious complications after button battery ingestion in children. Eur J Pediatr 2018; 177: 1063-1070
  • 17 Spiegel BM, Vakil NB, Ofman JJ. Endoscopy for acute nonvariceal upper gastrointestinal tract hemorrhage: Is sooner better? A systematic review. Arch Intern Med 2001; 161: 1393-1404