Today’s anesthesia gastroscopy technology can solve the problem of endoscopy in those young and uncooperative children. From the experience of our hospital endoscopy, the endoscopy of school-age children is basically the same as that of adults; the vast majority of preschool children and young children can be treated under proper preoperative sedation, and individual cases require anesthesia to be completed.
(A) Indications for pediatric gastroscopic endoscopic treatment
1, swallowing difficulties or painful swallowing: oropharyngeal or esophageal disorders should be excluded.
2, vomiting of unknown origin: vomiting caused by digestive system disorders should be excluded.
3.Unexplained chest pain: After excluding heart and lung disorders, chest pain is mostly seen in inflammation or ulceration of the esophagus, and its chest pain characteristics often occur with eating.
4, abdominal pain of unknown cause: It is a common clinical symptom in pediatrics, involving a wide range of functional and organic, and gastroscopy is very beneficial to confirm the diagnosis.
5, upper gastrointestinal bleeding: its primary cause, in addition to systemic diseases (such as hematologic diseases or serious infectious diseases), bleeding from the digestive system mostly comes from acute and slow inflammation of the esophagus, stomach and duodenum, peptic ulcer, bleeding from ruptured esophageal and fundic varices caused by portal hypertension, as well as hemangioma, allergic purpura, etc.
6, malabsorption and chronic inflammatory bowel disease: clinically, we often encounter children with refractory diarrhea or malabsorption, which generally show a long history, poor development and nutritional status, and it is difficult to find the cause with conventional examination methods. Such cases are suitable for endoscopy, which can observe the mucosal condition of the upper gastrointestinal tract, while mucosal biopsies can be taken from the esophagus, stomach and duodenum, and even the proximal jejunum, for pathological histological examination.
7, accidental swallowing of corrosive agents: can predict the healing.
8, endoscopic treatment: such as taking foreign bodies or roundworms in the gastrointestinal tract; stopping bleeding in the gastrointestinal tract; removing gastrointestinal polyps, etc.
(B) Contraindications and complications of upper gastrointestinal endoscopy
1, contraindications: acute pharyngitis, severe heart or respiratory diseases, acute phase of gastrointestinal perforation, and those whose general condition is difficult to withstand endoscopy.
2. Complications: After nearly 20 years of clinical practice, endoscopy has proved to be a safe and effective method in general.
(C) Application of lower gastrointestinal endoscopy (colonoscopy)
1.Indications
1, chronic diarrhea of unknown origin, mucus stool, mucus pus and blood stool.
2, diagnosis and treatment of acute and chronic gastrointestinal bleeding.
3, Removal of colon polyps.
4.Treatment of intussusception reset
5.X-ray barium meal imaging to detect suspicious lesions.
6.Removal of foreign body.
7.Observation of the treatment effect of post-colonic surgery and inflammatory bowel disease, etc.
2, Contraindications.
Necrotizing colitis, toxic megacolon, anal lesions with significant pain and patients with severe systemic disease.