Download PDF
Open Access
CC BY 4.0 · Journal of Digestive Endoscopy 2024; 15(01): 27-34
DOI: 10.1055/s-0043-1777736
Research Article

Lower Gastrointestinal Bleed in Children: Safety, Utility, and Yield of Colonoscopy: an Experience from a Large Tertiary Referral Endoscopy Center

Authors

  • Mohd Irtaza 

    1   Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

  • Sridhar Sundaram

    2   Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Mumbai, India

  • Amrit Gopan

    1   Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

  • Biswa Ranjan Patra 

    1   Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

  • Praveen Kumar Rao

    1   Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

  • Sanjay Kumar

    1   Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

  • Aditya P. Kale

    1   Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

  • Akash Shukla

    1   Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

Funding None.
Further Information
Also available at
  Permissions and Reprints

Abstract

Objective: There is paucity of data on lower gastrointestinal bleed (LGIB) in the pediatric population. We aimed to retrospectively review the endoscopy findings in patients younger than 18 years, presenting with lower gastrointestinal (GI) bleed and undergoing colonoscopy.

Materials and Methods: Retrospective review of the endoscopy database at the department of gastroenterology at a tertiary care center from Western India was conducted between June 2017 until December 2021. Patients ≤18 years with LGIB, who underwent colonoscopy within 7 days of onset of bleed, were included in the study. Demographic details, endoscopic findings, and complications were noted.

Results: In all, 55 patients were included in study (65% males; median age: 13 years [range: 1–18 years]). The most common endoscopic findings were polyps in 26 (47.2%) patients, colitis in 15 (27.2%) patients, solitary rectal ulcer syndrome (SRUS) in 6 (11.3%) patients, and hemorrhoids in 3 (5.4%) patients. Five (9%) patients had normal colonoscopy in whom the cause remained unidentified on further evaluation. However, no repeat episode was documented on a follow-up of 30 days. The most common location of a polyp was the rectum (64%). Two patients had multiple polyps (2 each). All the patients underwent a successful polypectomy. Pathology reported juvenile polyps in 25 biopsies. Four were diagnosed as inflammatory bowel disease (IBD), while 11 had acute infective colitis. Patients with infectious colitis as compared to IBD had higher incidence of fever (55 vs. 0%) and lesser incidence of previous similar events (22 vs. 66%). Those with polyps were younger than those without polyps (9.1 vs. 14.3 years; p = 0.000). Polyps were significantly more common in boys (84%; 22/26; p = 0.014) than in girls. No complications occurred in this cohort of patients.

Conclusions: Polyps are the most common cause of LGIB in patients ≤18 years, followed by colitis. Polyps were more common in younger males.

Keywords

colonoscopy - pediatric GI bleed - polyps

Statement and Declarations

The submitted work is original and has not been published elsewhere in any form or language.


This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was waived by the local ethics committee in view of the retrospective nature of the study and all the procedures being performed were a part of the routine care.


Author Contributions

All the authors contributed substantially to the study conception and design, analysis and interpretation of data, drafting the work or revising it critically for important intellectual content, and approved the final version of the manuscript to be published.




Publication History

Article published online:
27 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India