Clinical Endoscopy

Original Article

Exploring lumen-apposing metal stents as a novel approach for managing walled-off necrosis in pediatric acute pancreatitis in Indian cohort: a prospective study: Varun Mehta, Abhinav Abhinav, Yogesh Kumar Gupta, Manisha Khubber, Ajit Sood, Manjeet Kumar Goyal; Clin Endosc 2025;58(4):595-603. Published online May 29, 2025; DOI: https://doi.org/10.5946/ce.2024.315

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Background
/Aims: Walled-off necrosis (WON) is a severe complication of acute pancreatitis in children, with limited evidence on its endoscopic management. This study evaluated the efficacy and safety of endoscopic ultrasonography (EUS)-guided lumen-apposing metal stent (LAMS) placement for WON in pediatric patients.
Methods
This open-label prospective study included pediatric patients aged 5–18 years with WON secondary to acute necrotizing pancreatitis that was managed with EUS-guided LAMS at a tertiary center from January 2021 to July 2023. Clinical success, defined as symptom resolution and WON clearance at 12 weeks, was the primary outcome. Secondary outcomes included technical success, complications, and the need for additional interventions.
Results
Eleven patients (mean age, 15.5±3.1 years) were included. Clinical success was achieved in 90.9% of the patients within 12 weeks, with a 100% technical success rate. Two patients experienced stent occlusions that were managed with saline irrigation; one case required video-assisted retroperitoneal debridement. The mean hospital stay was 5.4±3.3 days. No major adverse events were reported.
Conclusions
EUS-guided LAMS placement is a safe and effective alternative to surgery for pediatric WON, with high clinical and technical success rates and minimal complications. Further multicenter studies are required to validate these findings.

Citations

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The evolving role of endoscopic ultrasound-guided lumen-apposing metal stents in the management of peri-pancreatic fluid collections
Ashita Rukmini Vuthaluru, Varun Mehta, Omesh Goyal, Prabhav Mehta, Manjeet Kumar Goyal
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef

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Systematic Review and Meta-analysis

Safety of endoscopic retrograde cholangiopancreatography (ERCP) in cirrhosis compared to non-cirrhosis and effect of Child-Pugh score on post-ERCP complications: a systematic review and meta-analysis: Zahid Ijaz Tarar, Umer Farooq, Mustafa Gandhi, Saad Saleem, Ebubekir Daglilar; Clin Endosc 2023;56(5):578-589. Published online May 2, 2023; DOI: https://doi.org/10.5946/ce.2023.027

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Background
/Aims: The safety of endoscopic retrograde cholangiopancreatography (ERCP) in hepatic cirrhosis and the impact of Child-Pugh class on post-ERCP complications need to be better studied. We investigated the post-ERCP complication rates in patients with cirrhosis compared with those without cirrhosis.
Methods
We conducted a literature search of relevant databases to identify studies that reported post-ERCP complications in patients with hepatic cirrhosis.
Results
Twenty-four studies comprising 28,201 patients were included. The pooled incidence of post-ERCP complications in cirrhosis was 15.5% (95% confidence interval [CI], 11.8%–19.2%; I2=96.2%), with an individual pooled incidence of pancreatitis 5.1% (95% CI, 3.1%–7.2%; I2=91.5%), bleeding 3.6% (95% CI, 2.8%–4.5%; I2=67.5%), cholangitis 2.9% (95% CI, 1.9%–3.8%; I2=83.4%), and perforation 0.3% (95% CI, 0.1%–0.5%; I2=3.7%). Patients with cirrhosis had a greater risk of post-ERCP complications (risk ratio [RR], 1.41; 95% CI, 1.16–1.71; I2=56.3%). The risk of individual odds of adverse events between cirrhosis and non-cirrhosis was as follows: pancreatitis (RR, 1.25; 95% CI, 1.06–1.48; I2=24.8%), bleeding (RR, 1.94; 95% CI, 1.59–2.37; I2=0%), cholangitis (RR, 1.15; 95% CI, 0.77–1.70; I2=12%), and perforation (RR, 1.20; 95% CI, 0.59–2.43; I2=0%).
Conclusions
Cirrhosis is associated with an increased risk of post-ERCP pancreatitis, bleeding, and cholangitis.

Citations

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Quality Indicators for ERCP
Michelle A. Anderson, Gregory A. Cote, Rajesh N. Keswani, Sarah A. Rodriguez, Uzma D. Siddiqui, B. Joseph Elmunzer
American Journal of Gastroenterology.2026; 121(1): 80. CrossRef
Post‐ERCP Outcomes in Cirrhotic Patients With Thrombocytopenia: A Propensity‐Matched Retrospective Comparative Analysis on TriNetX Health Research Database
Umar Hayat, Azhar Hussain, Hassam Ali, Karan J. Yagnik, Pranav Patel, Ali A. Siddiqui, Sumant Inamdar, Kamran Qureshi, Harshit S. Khara, Bradley Confer, David L. Diehl
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Zachary D. Leslie, Khalid Ahmed, Yasmin Ali, Eric S. Wise, Nabeel Azeem, Martin Freeman, Stuart K. Amateau, Ahmed Dirweesh
Digestive Diseases and Sciences.2026;[Epub] CrossRef
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Mohammed Abusuliman, Sanad Dawod, Faisal Nimri, Taher Jamali, Gordon Jacobsen, Muhammad Zarrar Khan, Remy Arwani, Omar Shamaa, Suhaib Alhaj Ali, Spandana Alluri, Rami Youssef, Abdulmalik Saleem, Ahmad Alomari, Muhammad Saad Faisal, Haya Omeish, Muhammad S
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Muaaz Masood, Shayan Irani, Mehran Fotoohi, Lauren Wancata, Rajesh Krishnamoorthi, Richard A. Kozarek
Journal of Clinical Medicine.2025; 14(14): 4997. CrossRef
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Linzhen Li, Di Wang, Xiaoping Niu
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Muaaz Masood, Sumant Inamdar, Ragesh B Thandassery
Digestive Diseases and Sciences.2025; 70(12): 4032. CrossRef
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Journal of Orthopaedic Surgery.2025;[Epub] CrossRef
The Impact of Frailty on ERCP-Related Adverse Events: Findings From a National Cohort
Umer Farooq, Zahid Ijaz Tarar, Abdallah El Alayli, Faisal Kamal, Alexander Schlachterman, Anand Kumar, David E. Loren, Thomas E. Kowalski
Techniques and Innovations in Gastrointestinal Endoscopy.2024; 26(2): 138. CrossRef
Applicability of Child-Turcotte-Pugh Score in Anticipating Post-ERCP Adverse Events in Patients With Cirrhosis
Saqr Alsakarneh, Fouad Jaber, Willie Mohammed, Mohammad Almeqdadi, Abdallah Al-Ani, Yassine Kilani, Saeed Abughazaleh, Laith Momani, Muhammad Shah Miran, Hassan Ghoz, John Helzberg, Wendell Clarkston, Mohamed Othman
Journal of Clinical Gastroenterology.2024; 58(6): 554. CrossRef
Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea
Hyung Ku Chon, Ki-Hyun Kim, Tae Jun Song, Dong-Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Tae Joo Jeon, Chang Hwan Park, Kwang Bum Cho, Dong Wook Lee, Jin-Seok Park, Seung Bae Yoon, Kwang Hyun Chung, Jin Lee, Miyoung Choi
Gut and Liver.2024; 18(4): 564. CrossRef
Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea
Ki-Hyun Kim, Hyung Ku Chon, Tae Jun Song, Dong Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Tae Joo Jeon, Chang Hwan Park, Kwang Bum Cho, Dong Wook Lee, Jin-Seok Park, Seung Bae Yoon, Kwang Hyung Chung, Jin Lee, Miyoung Choi
The Korean Journal of Gastroenterology.2024; 84(3): 111. CrossRef
Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea
Ki-Hyun Kim, Hyung Ku Chon, Tae Jun Song, Dong Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Tae Joo Jeon, Chang Hwan Park, Kwang Bum Cho, Dong Wook Lee, Jin-Seok Park, Seung Bae Yoon, Kwang Hyung Chung, Jin Lee, Miyoung Choi
The Korean Journal of Pancreas and Biliary Tract.2024; 29(4): 144. CrossRef
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY FOR THE MANAGEMENT OF CHOLEDOCHOLITHIASIS IN OLDER PATIENTS
Júlia Gardenyes, Pere Roura, Helena Vallverdú-Cartie, Judit Hermoso-Bosch, Cl�udia Roca, Mariona Espaulella, Antoni Casals, Héctor Ivo Marani, Joan Saló, Martín Galdín, Marta Gallach, Carles Leal
Revista Española de Enfermedades Digestivas.2023;[Epub] CrossRef

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Original Article

Endoscopic Yield, Appropriateness, and Complications of Pediatric Upper Gastrointestinal Endoscopy in an Adult Suite: A Retrospective Study of 822 Children: Manzoor Ahmad Wani, Showkat Ali Zargar, Ghulam Nabi Yatoo, Inaamul Haq, Altaf Shah, Jaswinder Singh Sodhi, Ghulam Mohammad Gulzar, Mushtaq Khan; Clin Endosc 2020;53(4):436-442. Published online April 7, 2020; DOI: https://doi.org/10.5946/ce.2019.118

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Background
/Aims: This study aimed to study the endoscopic yield, appropriateness, and complications of pediatric endoscopy performed by adult gastroenterologists in an adult endoscopic suite.
Methods
This a retrospective study in which records of all the patients less than 18 years of age who underwent endoscopy in the last 5 years were studied. The indications of endoscopy in children were categorized as appropriate or inappropriate per the latest guidelines by American Society for Gastrointestinal Endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Positive endoscopic yield was defined as the presence of any abnormality on endoscopy.
Results
Among the total of 822 children (age <18 years), the most common indications were variceal surveillance/eradication in 157 (19.1%), followed by dyspepsia in 143 (17.4%), upper gastrointestinal (UGI) bleeding in 136 (16.5%), recurrent abdominal pain in 94 (11.4%), unexplained anemia in 74 (9%), recurrent vomiting in 50 (6.08%), chronic refractory gastroesophageal reflux disease in 34 (4.1%) and others; 780 out of 822 endoscopic procedures (94.9%) done in children were appropriate as per the guidelines. The endoscopic yield was 45.8%, highest in patients with UGI bleeding (71.3%), followed by variceal surveillance (54.8%), recurrent vomiting (38%), dyspepsia (37.8%), and recurrent abdominal pain (36%). Minor adverse events occurred in 7.3% of children.
Conclusions
Pediatric endoscopy performed by an experienced adult gastroenterologist may be acceptable if done in cooperation with a pediatrician.

Citations

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Management of pediatric inflammatory bowel diseases in limited‐resource settings: A position paper from the Paediatric IBD Porto Group of ESPGHAN
Almuthe Christine Hauer, Mutaz Sultan, Andy Darma, Eyad Altamimi, Daniela Elena Serban, Amit Assa, Claudia Patricia Sánchez Franco, Lissy de Ridder, David C. Wilson, Nadeem Ahmad Afzal, Jiri Bronsky, Miglena Georgieva, Marina Aloi, Vaidotas Urbonas, Vícto
Journal of Pediatric Gastroenterology and Nutrition.2025; 81(3): 866. CrossRef
Which Alarm Symptoms Are Associated With Abnormal Gastrointestinal Endoscopy Among Thai Children?
Anundorn Wongteerasut
Pediatric Gastroenterology, Hepatology & Nutrition.2024; 27(2): 113. CrossRef
Paediatric gastrointestinal endoscopy in the Asian-Pacific region: Recent advances in diagnostic and therapeutic techniques
James Guoxian Huang, Pornthep Tanpowpong
World Journal of Gastroenterology.2023; 29(18): 2717. CrossRef
Gastrointestinal Bleeding in Children: The Role of Endoscopy and the Sheffield Scoring System in a Resource‐Limited Setting
Oluwafunmilayo Funke Adeniyi, Olufunmilayo Adenike Lesi, Emuobor Aghoghor Odeghe, Ganiyat Oyeleke, Nicholas Croft
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Pediatric esophagogastroduodenoscopy in china: indications, diagnostic yield, and factors associated with findings
Shengnan Wang, Xiaoxia Qiu, Jingfang Chen, Hong Mei, Haiyan Yan, Jieyu You, Ying Huang
BMC Pediatrics.2022;[Epub] CrossRef
Safety and Competency are the Main Priorities in Pediatric Endoscopy
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Clinical Endoscopy.2020; 53(4): 379. CrossRef

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Case Report

A Case of Eosinophilic Esophagitis Associated with Herpes Esophagitis in a Pediatric Patient: Jisun Kim, Kunsong Lee, Wonae Lee; Clin Endosc 2019;52(6):606-611. Published online July 17, 2019; DOI: https://doi.org/10.5946/ce.2019.021

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Eosinophilic esophagitis is a rare disease in Asian countries, but its incidence is growing rapidly in Western countries. The main pathophysiology of eosinophilic esophagitis is esophageal epithelial barrier dysfunction; disruption of the esophageal epithelial barrier easily induces antigen sensitization to foods and aeroallergens, which leads to subsequent esophageal inflammation as a result of eosinophil recruitment. Here we report a case of an 11-year-old Korean boy who suffered from fever, odynophagia, dysphagia, and chest pain. His upper endoscopic findings showed longitudinal ulcers with a volcano-like appearance at the distal esophagus. Polymerase chain reaction test results and biopsy specimens were positive for herpes simplex virus type 1. He was treated with acyclovir and a proton pump inhibitor, but his follow-up endoscopy showed typical patterns of eosinophilic esophagitis, and the biopsy specimens were compatible with the diagnostic criteria for eosinophilic esophagitis. Therefore, we report a very rare case of eosinophilic esophagitis after herpes esophagitis in a Korean child with normal immunity.

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A unique association between herpes simplex esophagitis and eosinophilic esophagitis: a case report
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Dysphagia and chest pain in a 7-year-old girl
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Laboratory Medicine.2025; 56(1): 97. CrossRef
РОЛЬ ГЕРПЕСВИРУСОВ В РАЗВИТИИ ХРОНИЧЕСКОГО ВОСПАЛЕНИЯ СЛИЗИСТОЙ ОБОЛОЧКИ ВЕРХНИХ ОТДЕЛОВ ОРГАНОВ ПИЩЕВАРЕНИЯ У ДЕТЕЙ
Анастасия Павловна Листопадова, Мария Олеговна Цепилова, Анастасия Алексеевна Горовая
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Mahdieh Ghoddoosi, Kimia Jazi, Zahra Hajrezaei, Mohammad Amin Habibi, Sajjad Ahmadpour, Mahdi Pezeshki Modares
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Focused Review Series: Endoscopys in Children

Pediatric Colonoscopy: The Changing Patterns and Single Institutional Experience Over a Decade: Jae Hong Park; Clin Endosc 2018;51(2):137-141. Published online March 30, 2018; DOI: https://doi.org/10.5946/ce.2018.051

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The safety and effectiveness of pediatric colonoscopy for lower gastrointestinal tract diseases have been established in Korea for about 30 years. Both diagnostic and therapeutic colonoscopies have had many advances in terms of operator skill and experience and are now being performed by most pediatric gastroenterologists. Pediatric colonoscopy is different in many aspects from that of adults, such as expected diagnoses, patient management, bowel preparation, selection criteria for sedation, and instrument selection. In this review, the author presents practical information on pediatric colonoscopy, the author’s experiences, and the changes in colonoscopy practices over a decade in a tertiary hospital in Korea.

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Foreign Body Ingestion in Children: Ji Hyuk Lee; Clin Endosc 2018;51(2):129-136. Published online March 30, 2018; DOI: https://doi.org/10.5946/ce.2018.039

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Foreign body (FB) ingestion in children is common and most children are observed to be between 6 months and 3 years of age. Although most FBs in the gastrointestinal tract pass spontaneously without complications, endoscopic or surgical removal may be required in a few children. Thus, FB ingestion presents a significant clinical difficulty in pediatric gastroenterological practice. Parameters that need to be considered regarding the timing of endoscopic removal of ingested FBs in children are the children’s age or body weight, the clinical presentation, time lapse since ingestion, time of last meal, type as well as size and shape of the FB, and its current location in the gastrointestinal tract. Esophageal button batteries require emergency removal regardless of the presence of symptoms because they can cause serious complications. Coins, magnets, or sharp FBs in the esophagus should be removed within 2 hours in symptomatic and within 24 hours in asymptomatic children. Among those presenting with a single or multiple magnets and a metallic FB that have advanced beyond the stomach, symptomatic children need a consultation with a pediatric surgeon for surgery, and asymptomatic children may be followed with serial X-rays to assess progression. Sharp or pointed, and long or large and wide FBs located in the esophagus or stomach require endoscopic removal.

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Sedation in Pediatric Esophagogastroduodenoscopy: Seak Hee Oh; Clin Endosc 2018;51(2):120-128. Published online March 30, 2018; DOI: https://doi.org/10.5946/ce.2018.028

Abstract PDF PubReader ePub

Pediatric esophagogastroduodenoscopy (EGD) has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies have been adopted to improve patient tolerance during pediatric EGD. For children, safety is a fundamental consideration during this procedure as they are at a higher risk of severe adverse events from procedural sedation compared to adults. Therefore, a detailed risk evaluation is required prior to the procedure, and practitioners should be aware of the benefits and risks associated with sedation regimens during pediatric EGD. In addition, pediatric advanced life support by endoscopists or immediate intervention by anesthesiologists should be available in the event that severe adverse events occur during pediatric EGD.

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Journal of Pediatric Gastroenterology and Nutrition.2019; 69(3): 281. CrossRef

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Case Reports

Ménétrier’s Disease as a Gastrointestinal Manifestation of Active Cytomegalovirus Infection in a 22-Month-Old Boy: A Case Report with a Review of the Literature of Korean Pediatric Cases: Jeana Hong, Seungkoo Lee, Yoonjung Shon; Clin Endosc 2018;51(1):89-94. Published online June 13, 2017; DOI: https://doi.org/10.5946/ce.2017.038

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Ménétrier’s disease (MD), which is characterized by hypertrophic gastric folds and foveolar cell hyperplasia, is the most common gastrointestinal (GI) cause of protein-losing enteropathy (PLE). The clinical course of MD in childhood differs from that in adults and has often been reported to be associated with cytomegalovirus (CMV) infection. We present a case of a previously healthy 22-month-old boy presenting with PLE, who was initially suspected to have an eosinophilic GI disorder (EGID). However, he was eventually confirmed, by detection of CMV DNA using polymerase chain reaction (PCR) with gastric tissue, to have MD associated with an active CMV infection. We suggest that endoscopic and pathological evaluation is necessary for the differential diagnosis of MD. In addition, CMV DNA detection using PCR analysis of biopsy tissue is recommended to confirm the etiologic agent of MD regardless of the patient’s age or immune status.

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Ménétrier’s disease: a narrative review of molecular pathogenesis, clinical spectrum and evolving therapeutic strategies
Tai Zhang, Ting Chen, Xudong Tang
QJM: An International Journal of Medicine.2026; 119(2): 85. CrossRef
Ménétrier Disease: A Scoping Review of Case Reports over the Last 10 Years
Conrad Baumeister, Julius Hüneburg
Bratislava Medical Journal.2025; 126(2): 127. CrossRef
Clinical Manifestation of Cytomegalovirus-Associated Protein-Losing Enteropathy in Children
Claire Ferrua, Anais Lemoine, Alexis Mosca, Anne-Aurélie Lopes
Nutrients.2023; 15(13): 2844. CrossRef
Menetrier disease and Cytomegalovirus infection in paediatric age: report of three cases and a review of the literature
Federica Barbati, Edoardo Marrani, Giuseppe Indolfi, Paolo Lionetti, Sandra Trapani
European Journal of Pediatrics.2021; 180(3): 679. CrossRef
Diagnosis and Management of Ménétrier Disease in Children: A Case Series Review
Jasmina Krikilion, Elvira Ingrid Levy, Yvan Vandenplas
Pediatric Gastroenterology, Hepatology & Nutrition.2021; 24(1): 109. CrossRef
Menetrier’s disease and differential diagnosis: A case report
Hou-Hong Wang, Can-Can Zhao, Xiao-Lei Wang, Ze-Nong Cheng, Zong-Yu Xie
World Journal of Clinical Cases.2021; 9(23): 6943. CrossRef
Ménétrier’s disease in a patient with refractory ulcerative colitis: a clinical challenge and review of the literature
Sofia Rao, Anna Viola, Omar Ksissa, Walter Fries
BMJ Case Reports.2021; 14(10): e246137. CrossRef

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Persistent Nonbilious Vomiting in a Child: Possible Duodenal Webbing: Rossella Angotti, Francesco Molinaro, Giovanni Cobellis, Carmine Noviello, Caterina Bocchi, Francesco Ferrara, Edoardo Bindi, Mario Messina; Clin Endosc 2017;50(2):191-196. Published online October 12, 2016; DOI: https://doi.org/10.5946/ce.2016.093

Abstract PDF PubReader ePub

An association between malrotation and congenital duodenal webbing is rare. We present our experience with four patients at two centers, and a review of published reports. There are currently 94 reported cases of duodenal pathology associated with malrotation. However, only 15 of the 94 cases (15.9%) include patients with malrotation and a duodenal web. We suggest that nonbilious vomiting in a child must prompt the surgeon to consider duodenal pathology even in the presence of malrotation.

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Gastric duplication presenting as partial gastric outlet obstruction
Giulia Fusi, Francesco Molinaro, Francesco Ferrara, Alessandra Taddei, Franco Roviello, Luigi Marano, Fabiola Rossi, Maurizio Costantini, Alessandro Cappelli, Mario Messina, Rossella Angotti
Journal of Pediatric Surgery Case Reports.2021; 64: 101723. CrossRef
Diagnosis and treatment of primary hypertrophic pyloric stenosis (HPS) in older children
C. Plessi, M. Sica, F. Molinaro, G. Fusi, F. Rossi, M. Costantini, F. Roviello, L. Marano, A. D'ignazio, C. Spinelli, R. Angotti
Journal of Pediatric Surgery Case Reports.2021; 69: 101860. CrossRef
Duodenal membranes: a late diagnosis evidenced by foreign bodies
G Maldonado, C Paredes, H Cedeño, I M Salcedo, M I Sanchez, E Fabre, M V Astudillo, J Gonzalez
Oxford Medical Case Reports.2017;[Epub] CrossRef

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Single Cavernous Hemangioma of the Small Bowel Diagnosed by Using Capsule Endoscopy in a Child with Chronic Iron-Deficiency Anemia: Soo Jin Bae, Geol Hwang, Hyun Sik Kang, Hyun Joo Song, Weon Young Chang, Young Hee Maeng, Ki-Soo Kang; Clin Endosc 2015;48(4):340-344. Published online July 24, 2015; DOI: https://doi.org/10.5946/ce.2015.48.4.340

Abstract PDF PubReader ePub

Cavernous hemangiomas of the gastrointestinal tract are extremely rare. In particular, the diagnosis of small bowel hemangiomas is very difficult in children. A 13-year-old boy presented at the outpatient clinic with dizziness and fatigue. The patient was previously diagnosed with iron-deficiency anemia at 3 years of age and had been treated with iron supplements continuously and pure red cell transfusion intermittently. Laboratory tests indicated that the patient currently had iron-deficiency anemia. There was no evidence of gross bleeding, such as hematemesis or bloody stool. Laboratory findings indicated no bleeding tendency. Gastroduodenoscopy and colonoscopy results were negative. To obtain a definitive diagnosis, the patient underwent capsule endoscopy. A purplish stalked mass was found in the jejunum, and the mass was excised successfully. We report of a 13-year-old boy who presented with severe and recurrent iron-deficiency anemia caused by a cavernous hemangioma in the small bowel without symptoms of gastrointestinal bleeding.

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Multiple small bowel cavernous hemangiomas complicated with intussusception presenting with intestinal obstruction: rare case report from Sudan and literature review
Jaber Hamad Jaber Amin, Mohamedelmustafa Yahya Mohamed Eldouma, Azza Ali Osman Mohammed, Shafee S Almahi
International Journal of Surgery Case Reports.2026; 138(4): 1391. CrossRef
Cavernous hemangioma of the small intestine in a child as a cause of anemia - a case report
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Pediatrie pro praxi.2026; 27(2): 131. CrossRef
Solitary Ileal Hemangioma in a 3-year-old Male
Jitendra Kumar Singh, Prakshi Solanki, Kaleem Usmani
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From Severe Anemia to Intestinal Hemangiomatosis, a Bumpy Road—A Case Report and Literature Review
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Frequency of Hematologic and Nonhematologic Conditions in Pediatric Patients with Vascular Anomalies: A Pediatric Health Information System Database Study
Bryony Lucas, Sindhoosha Malay, Irina Pateva
Journal of Vascular Anomalies.2024; 5(2): e080. CrossRef
Management of a small bowel hemangioma causing intussusception in an infant: A rare case report and literature review
Imen Helal, Anis Hasnaoui, Aida Daïb, Raja Jouini, Fatma Khanchel, Ashraf Chadli Debbiche
International Journal of Surgery Case Reports.2024;[Epub] CrossRef
Multiple Small Bowel Cavernous Hemangiomatosis: Case Report and Literature Review
Francesca Ré, Salvatore Carrabetta, Eugenio Merlo, Pietro Bisagni
Medicina.2024; 60(10): 1664. CrossRef
Cavernous hemangioma of the small intestine diagnosed by capsule endoscopy in an 8-year-old girl
Masaki Shinohara, Makoto Suzuki, Ryota Koyama, Yasuyuki Uchida, Kenjiro Ogushi, Sayaka Otake, Hideki Yamamoto, Takashi Ishige, Ken Shirabe
Journal of Pediatric Surgery Case Reports.2022; 83: 102337. CrossRef
Successful Endoscopic Sclerotherapy Using Polidocanol for Small Bowel Hemangioma
Taiki Aoyama, Akira Fukumoto, Kenjiro Shigita, Naoki Asayama, Shinichi Mukai, Shinji Nagata
Internal Medicine.2020; 59(14): 1727. CrossRef
Cavernous Hemangioma: A Rare Cause of Massive Lower Gastrointestinal Bleeding
Amna Al-Tkrit, Mohammad Aneeb, Andrew Mekaiel, Firas Alawawdeh, Asit Mehta
Cureus.2020;[Epub] CrossRef
Small bowel hemangioma in a 7-years-old boy, complicated by bleeding
V. P. Gavrilyuk, E. V. Donskaja, D. A. Severinov
Grekov's Bulletin of Surgery.2020; 179(4): 98. CrossRef
Unusual presentation of jejunal hemangioma on Tc-99m pertechnetate scan with single-photon emission computerized tomography-computed tomography
Karan Peepre, Nitinkumar Borkar, Sunil N. Jondhale, Mudalsha Ravina, Amal Moideen, Vipin Yadav, Sushmita Dey
World Journal of Nuclear Medicine.2019; 18(03): 310. CrossRef
CAVERNOUS HEMANGIOMA OF THE JEJUNUM, AS A SOURCE OF RECURRENT INTESTINAL BLEEDING IN A 11-YEAR-OLD CHILD
O. V. Karaseva, A. L. Gorelik, A. Yu. Kharitonova, A. V. Timofeeva, D. E. Golikov, K. E. Utkina, A. N. Kislyakov, I. V. Filinov, L. M. Roshal
Russian Journal of Pediatric Surgery.2019; 23(1): 27. CrossRef
Small intestinal hemangioma: Endoscopic or surgical intervention? A case report and review of literature
Ping-Fang Hu, Han Chen, Xiao-Hang Wang, Wei-Jun Wang, Ning Su, Bin Shi
World Journal of Gastrointestinal Oncology.2018; 10(12): 516. CrossRef
Surgical treatment of gemangioma of the small intestine complicated by recurrent bleedings and blood losses of heavy severity
I A Soloviev, M V Vasilchenko, S V Voloshin, A V Kudryavtseva, A V Kolunov, T E Koshelev, N A Sizonenko
Bulletin of the Russian Military Medical Academy.2018; 20(4): 52. CrossRef
A very rare cause of abdominal pain in a male adolescent: cavernous hemangioma
Hsiang-Ju Hsiao, Yi-Jung Chang, Jin-Yao Lai, Chao-Jan Wang, I-Anne Huang, Chang-Teng Wu
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Vascular Anomalies and Inflammatory Bowel Disease
Pierre Ellul, John Schembri
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A Rare Cause of Recurrent Gastrointestinal Bleeding: Giant Diffuse and Cavernous Intestinal Mesentery Hemangioma in an Adult
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Digestive Diseases and Sciences.2016; 61(11): 3363. CrossRef

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Original Article

Propofol versus Midazolam for Sedation during Esophagogastroduodenoscopy in Children: Ji Eun Oh, Hae Jeong Lee, Young Hwan Lee; Clin Endosc 2013;46(4):368-372. Published online July 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.4.368

Abstract PDF PubReader ePub

Background/Aims

To evaluate the efficacy and safety of propofol and midazolam for sedation during esophagogastroduodenoscopy (EGD) in children.

Methods

We retrospectively reviewed the hospital records of 62 children who underwent ambulatory diagnostic EGD during 1-year period. Data were collected from 34 consecutive patients receiving propofol alone. Twenty-eight consecutive patients who received sedation with midazolam served as a comparison group. Outcome variables were length of procedure, time to recovery and need for additional supportive measures.

Results

There were no statistically significant differences between the two groups in age, weight, sex, and the length of endoscopic procedure. The recovery time from sedation was markedly shorter in propofol group (30±16.41 minutes) compared with midazolam group (58.89±17.32 minutes; p<0.0001). During and after the procedure the mean heart rate was increased in midazolam group (133.04±19.92 and 97.82±16.7) compared with propofol group (110.26±20.14 and 83.26±12.33; p<0.0001). There was no localized pain during sedative administration in midazolam group, though six patients had localized pain during administration of propofol (p<0.028). There was no serious major complication associated with any of the 62 procedures.

Conclusions

Intravenous administered propofol provides faster recovery time and similarly safe sedation compared with midazolam in pediatric patients undergoing upper gastrointestinal endoscopy.

Citations

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Procedural Sedation for Pediatric Upper Gastrointestinal Endoscopy in Korea
Yoo Min Lee, Ben Kang, Yu Bin Kim, Hyun Jin Kim, Kyung Jae Lee, Yoon Lee, So Yoon Choi, Eun Hye Lee, Dae Yong Yi, Hyo-Jeong Jang, You Jin Choi, Suk Jin Hong, Ju Young Kim, Yunkoo Kang, Soon Chul Kim
Journal of Korean Medical Science.2021;[Epub] CrossRef
Safety and Recipient Satisfaction of Propofol Sedation in Outpatient Endoscopy: A 24-Hour Prospective Investigation Using a Questionnaire Survey
Yoshihide Kanno, Tetsuya Ohira, Yoshihiro Harada, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Yoshiki Koike, Taku Yamagata, Toshitaka Sakai, Kaori Masu, Keisuke Yonamine, Kazuaki Miyamoto, Megumi Tanaka, Tomohiro Shimada, Fumisato Kozakai, Kazuki
Clinical Endoscopy.2021; 54(3): 340. CrossRef
Safety of Non-anesthesiologist Administration of Propofol for Gastrointestinal Endoscopy
Jun Kyu Lee, Dong Kee Jang, Won Hee Kim, Jung-Wook Kim, Byung Ik Jang
The Korean Journal of Gastroenterology.2017; 69(1): 55. CrossRef
Analysis of Adverse Events Associated With Adult Moderate Procedural Sedation Outside the Operating Room
Sergey Karamnov, Natalia Sarkisian, Rebecca Grammer, Wendy L. Gross, Richard D. Urman
Journal of Patient Safety.2017; 13(3): 111. CrossRef
Methods for prevention of complications during eyelid and peri-orbital surgery
P. Tan, W.F. Siah, R. Malhotra
Expert Review of Ophthalmology.2016; 11(4): 311. CrossRef
Complications in pediatric endoscopy
Andrea Tringali, Valerio Balassone, Paola De Angelis, Rosario Landi
Best Practice & Research Clinical Gastroenterology.2016; 30(5): 825. CrossRef
Propofol-alfentanyl versus midazolam-alfentanyl in inducing procedural amnesia of upper gastrointestinal endoscopy in children—blind randomised trial
Edyta Sienkiewicz, Piotr Albrecht, Janusz Ziółkowski, Piotr Dziechciarz
European Journal of Pediatrics.2015; 174(11): 1475. CrossRef
Prevalence of Chronic Gastritis or Helicobacter pylori Infection in Adolescent Sleeve Gastrectomy Patients Does Not Correlate with Symptoms or Surgical Outcomes
Ashanti L. Franklin, Emily S. Koeck, Miller C. Hamrick, Faisal G. Qureshi, Evan P. Nadler
Surgical Infections.2015; 16(4): 401. CrossRef
Barbiturate Induction for the Prevention of Emergence Agitation after Pediatric Sevoflurane Anesthesia
Tadasuke Use, Haruna Nakahara, Ayako Kimoto, Yuki Beppu, Maki Yoshimura, Toshiyuki Kojima, Taku Fukano
The Journal of Pediatric Pharmacology and Therapeutics.2015; 20(5): 385. CrossRef
Same-day bidirectional endoscopy with nonanesthesiologist administration of propofol
Alfredo J. Lucendo, Ángel Arias, Sonia González-Castillo, Teresa Angueira, Danila Guagnozzi, Mariluz Fernández-Fuente, Mercedes Serrano-Valverde, Marta Sánchez-Cazalilla, Oliver Chumillas, Maruja Fernández-Ordóñez, José M. Tenías
European Journal of Gastroenterology & Hepatology.2014; 26(3): 301. CrossRef
Endoscopist-Directed Propofol: Pros and Cons
Eun Hye Kim, Sang Kil Lee
Clinical Endoscopy.2014; 47(2): 129. CrossRef
Comparison of Midazolam and Propofol for Sedation in Pediatric Diagnostic Imaging Studies
Ahmet Sebe, Hayri Levent Yilmaz, Zikret Koseoglu, Mehmet Oguzhan Ay, Muge Gulen
Postgraduate Medicine.2014; 126(3): 225. CrossRef
Endoscopic Sedation: From Training to Performance
Tae Hoon Lee, Chang Kyun Lee
Clinical Endoscopy.2014; 47(2): 141. CrossRef
Harmony of Duet over Solo: Use of Midazolam or Propofol for Sedative Endoscopy in Pediatric Patients
Kwang Hyun Ko, Ki Baik Hahm
Clinical Endoscopy.2013; 46(4): 311. CrossRef

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A Single Institution's Experience of Ten Pediatric Patients with Endoscopic Retrograde Cholangiopancreatography: Jin Woo Park, M.D., Sang-Heum Park, M.D., Tae Hoon Lee, M.D., Yun Suk Shim, M.D., Soon Oh Hwang, M.D., Sang Pil Kim, M.D., Jun Young Lee, M.D., Seo Whan Lee, M.D., Chang Kwun Lee, M.D., Do Hyun Park, M.D.*, Suck Ho Lee, M.D., Il Kwun Chung, M.D., Hong Soo; Korean J Gastrointest Endosc 2010;41(3):140-146. Published online September 30, 2010

Abstract PDF

Background/Aims: ERCP is being used increasingly as a diagnostic and therapeutic tool for children with pancreaticobiliary disorders. Differences between thirteen pediatric ERCPs and adult ERCPs were reviewed with respect to their indications, method of anesthesia, choice of endoscope and complications.

Methods: The medical records of 13 ERCPs for 10 children (age: 23 months to 14 years) done between 2005 and 2008 were reviewed retrospectively.

Results: ERCP was indicated for gallstone pancreatitis (6), choledocholithiasis (3), and unexplained pain (1). The method of anesthesia was intravenous sedation with a single agent or a combination of midazolam, propofol or ketamine. The quality of sedation was satisfactory in 10 cases and unsatisfactory in three cases. These 3 cases were less than 8 years old and sedated with a combination of midazolam and propofol. Selective biliary cannulation was successful in 92.3% (12/13) of attempts. Therapeutic ERCP included sphincterotomy (4), endoscopic papillary balloon dilatation (3), and both (5). Complications occurred in 7.7% of attempts (1/13; 1 duodenal perforation) which was successfully managed by surgery.

Conclusions: Pediatric ERCP is a feasible and useful technique. Special caution is needed, however, because of differences with adult ERCP in terms of the effectiveness of intravenous sedation, complications, and size of the gastrointestinal tract. (Korean J Gastrointest Endosc 2010;41:140-146)

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Usefulness of Capsule Endoscopy in Children with Suspected Small Bowel Disease: Hae Jin Park, M.D., So Yeon Lee, M.D., Jae Sung Ko, M.D. and Jeong Kee Seo, M.D.; Korean J Gastrointest Endosc 2009;39(6):346-351. Published online December 30, 2009

Abstract PDF: Background
/Aims: The aim of our study is to investigate the diagnostic value and safety of capsule endoscopy (CE) in the pediatric patients with small bowel (SB) disease.
Methods
We retrospectively reviewed the records of 29 children (mean age: 11.8 year) who underwent CE at Seoul National University Children's Hospital between November 2004 and April 2009.
Results
Six (20%) of the total 29 patients could not swallow the capsule (mean age: 10.5 years), so the capsule was endoscopically placed into the stomach of these 6 patients. The CE examination for the entire SB was finished in 89.6% of the patients. The indications for CE studies were obscure gastrointestinal bleeding (OGIB) or anemia in 14 patients, intestinal polyposis in 8, abdominal pain in 4 and Crohn's disease in 3. The diagnostic yield of CE was 35.7% for OGIB or anemia, 37.5% for intestinal polyposis, 25% for abdominal pain and 33.3% for Crohn's disease. One patient had capsule retention during our CE investigations.
Conclusions
CE is a safe and valuable tool for the detection of SB Crohn's disease, the focus of OGIB and the presence of SB polyps in pediatric patients. (Korean J Gastrointest Endosc 2009;39:346-351)

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A Case of Dieulafoy-like Lesion with Massive Bleeding at Ileocecal Valve Following Acute Infectious Colitis in a Pediatric Patient: Jae Seung Soh, M.D., Seong Hun Kim, M.D., Yoon Jae Lee, M.D., In Hee Kim, M.D., Sang Wook Kim, M.D., Seung Ok Lee, M.D., Dae Ghon Kim, M.D. and Soo Teik Lee, M.D.; Korean J Gastrointest Endosc 2009;39(3):166-168. Published online September 30, 2009

Abstract PDF: The common causes of lower gastrointestinal bleeding in children are intussusception, rectal juvenile polyp, chronic inflammatory colitis and Meckel's diverticulum. Bleeding from Dieulafoy's ulcer at the lower gastrointestinal tract is rare, but this often occurs in the rectum. So far, there has been no report that a Dieulafoy lesion in the ileocecal valve might be formed after acute colitis in a pediatric patient. In this case report, a Dieulafoy-like lesion at the ileocecal valve caused lower gastrointestinal bleeding in an asymptomatic 14-year-old woman. A careful history taking and medical examination are mandatory to identify the bleeding focus in the GI tract and this can be treated by endoscopy. (Korean J Gastrointest Endosc 2009;39:166-168)

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Clinical Features and Course of Crohn Disease in Children: Na Young Lee, M.D. and Jae Hong Park, M.D.*; Korean J Gastrointest Endosc 2007;34(4):193-199. Published online April 30, 2007

Abstract PDF: Background
/Aims: The aim of this study was to evaluate the clinical features and course of Crohn disease (CD) in children. Methods: The medical records of 30 patients diagnosed with CD between January 1996 and December 2005 were reviewed retrospectively. Results: The actual number of newly diagnosed patients with CD has increased during the 8-year period. The male/female ratio was 2：1 and the mean age at diagnosis was 10.6⁑4.3 years. The major symptoms of CD at diagnosis were abdominal pain (79.2%), weight loss (54.2%), perianal lesion (54.2%), diarrhea (45.8%), hematochezia (41.7%), anemia (29.2%), and fever (23.3%). The disease location of CD was the small bowel in 33.3%, the large bowel in 12.5% and both the small and large bowel in 54.2%. Granuloma was found in 54.2% of patients. The relapse rate of CD in the group with a higher pediatric Crohn disease activity index (PCDAI) at diagnosis (≥30) was higher than in the group with a lower PCDAI (＜30). The cumulative relapse rates of the patients with granuloma were 30.2% within 1 year and 53.8% within 5 years after the diagnosis. Conclusions: The incidence of CD in children appears to be increasing. Granuloma formation and a higher score of the PCDAI are associated with a more severe disease course. Pediatric CD may have a somewhat different clinical presentation from older-onset CD. (Korean J Gastrointest Endosc 2007;34:193⁣199)

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A Case of Ingested Two Magnets Attracted Each Other that were Holding Gastric Mucosa: Min-Ji Goo, M.D., Ji-Sook Park, M.D., Seok-Jin Kang, M.D.*, Hyun-Jin Kim, M.D.*, Ji-Hyun Seo, M.D., Hyang-Ok Woo, M.D. and Hee-Shang Youn, M.D.; Korean J Gastrointest Endosc 2006;32(4):275-277. Published online April 30, 2006

Abstract PDF: Foreign body ingestion is common in children. About 80% of ingested foreign bodies spontaneously pass through gastrointestinal tract. The management of an ingested magnet depends on its size, the same as for other foreign bodies. However, it has been reported that magnetic foreign body ingestion can lead to gastrointestinal fistula. We report here on the case of a 13-month-old boy who ingested two magnet bars that attracted to each other, and they were holding the gastric mucosa. A simple abdomen X-ray revealed that the location of two magnet bars was not changed according to the patient's positional change. The magnet bars were removed with an alligator forcep under gastroduodenal endoscopy. (Korean J Gastrointest Endosc 2006;32:275⁣277)

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Clinical Review of Percutaneous Endoscopic Gastrostomy (PEG) in Children: Jae Hong Park, M.D., Bung Ho Choi, M.D.*, Kwang Hae Choi, M.D.^† and Jae Young Kim, M.D.^‡; Korean J Gastrointest Endosc 2005;31(5):291-296. Published online November 30, 2005

Abstract PDF: Background
/Aims: Percutaneous endoscopic gastrostomy (PEG) is a simple, safe and rapid method for the placement of a feeding gastrostomy tube and it is a well- established mean of providing enteral nutrition. Although it is frequently used in adults, there is limited experience for this procedure in children. Methods: Twenty five procedures of PEG in 23 patients were performed in four institutions located in Youngnam province. We retrospectively reviewed our experiences of PEG. Results: Fourteen males and nine females were included and their mean age was 5.7⁑4.1 years. The patients aged 1 to 6 years accounted for about a half the subjects. The underlying diseases of the patients were CNS disorders in all except one who was suffering with a neuromuscular disorder. The main reason for PEG was swallowing difficulty and the associated complications of the patients. Nasogastric tube feeding was the most common method of nutritional support before the procedures. The most common complication of PEG placement was wound infection. The patients' nutritional status after PEG placement was satisfactorily improved. The indwelling time of PEG tube was over 6 months in 2 of 3 patients and the tube was switched for a new one after a year. Removal of the tubes by using percutaneous traction was done in 2 of 3 patients. Conclusions: The PEG is a safe, easy to perform, and reliable technique to support enteral nutrition in children. (Korean J Gastrointest Endosc 2005;31:291⁣296)

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A Case of Successful Treatment of a Bleeding Duodenal Ulcer with Endoscopic Hemoclipping in a Child: Kon Ho Shim, M.D., Young Seok Cho, M.D., Chul Hyun Lim, M.D., Yoon Seok Koh, M.D.,Jun Chang Song, M.D., Jong Hyun Park, M.D., Sung Soo Kim, M.D., Hiun Suk Chae, M.D.,Myung Gyu Choi, M.D., Chang Don Lee, M.D., Kyu Yong Choi, M.D.,In Sik Chung, M.D. and Jin; Korean J Gastrointest Endosc 2004;29(2):80-84. Published online August 30, 2004

Abstract PDF: Upper gastrointestinal bleeding in infant and children is much less common than that in adults. Upper gastrointestinal bleeding in infants and young children is most often acssociated with stress ulcer or erosions, but in older children it may also be caused by duodenal ulcer, esophagitis, and esophageal varices. Because the total blood volume of a child is relatively small and can deplete rapidly, gastrointestinal bleeding is a catastrophic event. However, it is not associated with significant mortality except in those with a severe primary illness. Data on therapeutic endoscopy for pediatric gastrointestinal bleeding are limited to case reports. The hemoclip has recently been added to armamentaria of endoscopic devices. This method has several advantages, including fewer complication and the fact that less expertise is needed to achieve permanent hemostasis. We report a case of successful endoscopic control of a bleeding duodenal ulcer using with a hemoclip in a 22-month-old boy. Endoscopic hemoclipping would be a safe and efficacious treatment for control of bleeding from peptic ulcers in children. (Korean J Gastrointest Endosc 2004;29:80⁣84)

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소아에서 5분 속성 H. pylori 대변항원검사의 진단 정확도에 대한 평가: Korean J Gastrointest Endosc 2003;27(5):388-388. Published online November 20, 2003

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Helicobacter pylori 양성인 만성 반복성 복통 환아에 대한 제균 요법의 효과: Korean J Gastrointest Endosc 2003;27(5):386-386. Published online November 20, 2003

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Endoscopic Retrograde Cholangiopancreatography in Thirty-four Children: Sung Hee Jung, M.D.^‡, Kyung Mo Kim, M.D.*, Dong Wan Seo, M.D., Bo Hwa Choi, M.D.*, Chong Hyun Yoon, M.D.^†, Ji Yeol Yoon, M.D., Jung Ho Kim, M.D., Sung Koo Lee, M.D., Myung Hwan Kim, M.D. and Young Il Min, M.D.; Korean J Gastrointest Endosc 2003;26(6):418-425. Published online June 30, 2003

Abstract PDF: Background
/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is being used with increasing frequency as a diagnostic and therapeutic tool in children with suspected disorders of the pancreaticobiliary tract. We reviewed ERCPs performed in children and investigated clinical indications and usefulness of ERCP. Methods: A total of 80 ERCPs were performed in 34 patients (age: 17 months∼15 yrs) at Asan Medical Center from 1994 to 2001. Adult side-viewing duodenoscope, Olympus JF or TJF, was used for all procedures. General anesthesia was used in 73% of the patients, whereas intravenous sedation was employed in the remainder. Results: Cannulation was successful in 77 attempts (96%). ERCP was commonly indicated for the evaluation of pancreatic disease (18 cases) such as acute pancreatitis (4), recurrent pancreatitis (4), chronic pancreatitis (9), and non-resolving acute pancreatitis (1). Biliary tract diseases (15 cases) were common bile duct stones (4), choledochal cyst (8), and traumatic or nontraumatic common bile duct stricture (3). Therapeutic ERCP (n=20) included sphincterotomy (55.9%), insertion of stents (12%), and removal of common bile duct stones or pancreatic duct stones with balloon or basket (32%). The complications were developed in 12 out of 80 attempts (15%) and resolved with medical management. Conclusions: ERCP seems to be a useful and relatively safe procedure in the evaluation of pancreaticobiliary disorders in children and also can be used for nonoperative treatment of these diseordrs. (Korean J Gastrointest Endosc 2003;26:418⁣425)

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1 개 병원에서 경험한 소아 식도이물 적출방법 변화에 대한 고찰: Korean J Gastrointest Endosc 2001;23(5):291-291. Published online November 30, 2000

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소아 상부 위장관 이물의 내시경적 적출술 - 대구, 경북지역 소아 78예에 대한 고찰 - ( Endoscopic Removal of Foreign Bodies from the Upper Gastrointestinal Tract in Children: Management of 78 Cases in Taegu, Korea ): Korean J Gastrointest Endosc 2000;20(1):6-13. Published online November 30, 1999

Abstract PDF: Background
/Aims: Foreign body (FB) removal is a common indication of therapeutic endoscopy in children. The trend is becoming wider and more rational in application. The spectrum of upper gastrointestinal FB's in children during a recent 2 year period was reviewed in Taegu, Kyungbook Province in order to obtain a the consensus of recent trend of indications and techniques of endoscopic FB removal in children. Methods: Esophagogastroscopy was performed on 78 children who had been referred to 3 University Hospitals in Taegu for FB ingestion from Oct. 1996 to Sep. 1998. Results: Age between 1∼2 year was the peak age group; 22 cases (28%). Male to female ratio was 1.9：1. Thirty four cases (44%) were in the esophagus, 44 cases (56%) in the stomach. The majority (49%) of the FB's were coins, 26 of 34 esophageal FB's and 12 of 44 gastric FB's. Others were 14 sharp/pointed objects, 12 big/long objects, 7 toxic objects, etc. In 67 children (86%) the FB was successfully removed and spontaneous passage through the pylorus was observed in 9 children. Conclusions: Endoscopic FB removal can be performed safely and effectively in children with minimal or no complications by an experienced endoscopist. Proper arrangement should be conducted with consideration to the property of FB's, expected complication, and the possibility of an emergency situation. (Korean J Gastrointest Endosc 2000;20:6~13)

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13세 여아에서 발생한 담관낭종 합병의 담도암 1 예 ( A Case of Bile Duct Cancer Arising in Choledochal Cyst in a 13-Year-Old Girl ): Korean J Gastrointest Endosc 2000;21(4):811-814. Published online November 30, 1999

Abstract PDF: Choledochal cyst, also referred to as cystic dilatation of the extrahepatic bile duct, is a rare malformation most frequently seen in female. Malignant changes in choledochal cyst have frequently been described, but only one case of malignant change in childhood has been reported till now. Recently, we experienced a case of bile duct cancer arising in choledochal cyst in a 13-year-old girl. She had been complaining of right upper abdominal pain for 15 days. Abdominal CT scan and ERCP showed a cylindrical dilatation of extrahepatic bile duct with irregular cystic wall mass and multiple liver metastasis which was confirmed as adenocarcinoma by ultrasono-guided needle biopsy. Anomalous pancreaticobiliary ductal union was not seen. This patient was the youngest case of bile duct carcinoma arising in choledochal cyst in Korea.

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증례 : 식도 위장관 ; 만성복통을 주증상으로 한 면역기능이 정상인 소아에서 발생한 식도 캔디다증 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Esophageal Candidiasis Presenting Recurrent Abdominal Pain in an Immunocompetent Child ): Korean J Gastrointest Endosc 1997;17(1):55-58. Published online November 30, 1996

Abstract PDF: Candida albicans is the most common cause of infectious esophagitis and usually is an opportunistic infection in immunocompromised patients. Dysphagia and odynophagia are the usual presenting complaints and, importantly, oral lesions are absent in 50 percent of patients. The role of gastrointestinal endoscopy in diagnosing fungal infections of the esophagus is primary. It is the most definitive and often the only method of detecting esophageal candidiasis. Accurate endoscopic diagnosis by biopsy or brushing leads to the initiation nf effective therapy. We have experienced a case of esophageal candidiasis in an 11-year-old girl who was immunologically normal and whose main symptoms were epigastric abdominal pain and nausea for 4 months. The endoscopic and pathologic findings of esophageal candidiasis were presented. (Korean J Gastrointest Endosc 17: 55-58, 1997)

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증례 : 식도위장관 ; 철분제 과다복용 환아에서 위내시경을 이용한 구명치료 ( Case Reports : Esophagus , Stomach & Intestine ; Rescue of Child with Accidental Overingestion of Iron Tablets by Gastroscope ): Korean J Gastrointest Endosc 1997;17(6):801-805. Published online November 30, 1996

Abstract PDF: Iron overdose is one of the most common, potentially fatal intoxication in children. We rescued a 3-year-old girl who ingested about 20 iron tablets(110 mg/kg of elemental iron) with early endoscopic intervention. The stomach showed diffusc hemorrhagic gastritis with large amount of retained corrosive iron material. Removal of iron tablets was performed successfully by gastroscope with condom attached on its tip and she recovered completely without any sequelae. The severity of the endoscopic findings even in the early stage and the uneventful clinical recovery in our patient strongly support that this approach could be tried before traditional methods. We think that gastroscopy can be both diagnostic and therapeutic tool in acute drug intoxication in children, because of its safety and easy, rapid availability. (Korean J Gastrointest Endosc 17: 801-805, 1997)

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소아 H. pylori 위염의 혈청학적 진단 : 정상 학동기 아동과 위장관 증상 환아에서의 유병실태 및 혈청학적 진단의 정확도에 관한 연구 ( Serologic Diagnosis of Helicobacter pylori Gastritis in Children : Seroepidemiology of H. pylori in Normal School Children and Diagnostic Accuracy of IgG GAP Test in Children with Gastrointestinal Symptoms ): Korean J Gastrointest Endosc 1993;13(4):673-684. Published online November 30, 1992

Abstract PDF: For the detection of Helicobacter pylori infection, endoscopic biopsy related tests auch as urease test, culture, and histology with special staining of bacteria are most widely used standard methods and most accurate. (continue...)

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소아에서 발생한 조기위암 1예 ( A Case of Early Gastric Cancer in Childhood ): Korean J Gastrointest Endosc 1992;12(2):259-261. Published online November 30, 1991

Abstract PDF: The incidence of gastric cancer is high in old age group and low in young age group, extremely rare in child age. So the diagnosis of gastric cancer in young age is often delayed, and this, with other factors such as poorly differentiated histopathologic tendency and rapid growing nature, makes the prognosis poorer than in other age guoup. Therefore it should always be remembered that the young who has gastric symptom may have malignancy in his stomach in spite of the age. We report a case of early gastric cancer in a 16-years old male with the review of the literature.

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