Role of endoscopic ultrasound in pediatric patients: A single tertiary center experience and review of the literature

Table 1 Population characteristics and indications for endoscopic ultrasound

Children	n = 13
Females/males	8/5
Age (median)	15.6 yr
Age (range)	6-18 yr
Indications for EUS (n)	13
Upper
Thoracic
Tracheal mass	1
Mediastinal mass	2
Abdominal
Pancreatic head mass	1
Retroperitoneal mass	1
Ampullary mass	1
Abdominal lymphadenopathy	1
Peri-gastric mass	2
Suspected insulinoma	3
Lower
Rectal subepithelial lesion	1
EUS-FNA (n)	7
Solid	5
Cystic	2
Adverse events (n)	0

EUS: Endoscopic ultrasound; EUS-FNA: Endoscopic ultrasound-guided fine needle aspiration.

Table 2 Details of endoscopic ultrasound procedures

N	Age	Sex	Indication	EUS findings	EUS-FNA	Diagnosis	Treatment
1	17	F	Tracheal mass assessment before surgery	Hypoechoic tracheal mass measuring 13 mm × 9.5 mm separable from esophageal wall	Nil	Tracheal fibroma	Surgery
2	15	F	Pancreatic head mass	Isoechoic pancreatic head mass with hypoechoic rim about 30 mm × 25 mm separable from all vessels	22G	Well differentiated NET	Surgery
3	12	F	Retroperitoneal mass	Isoechoic mass with small cystic areas about 60 mm × 60 mm compressing the SMA	19G	SPN	Surgery
4	15	F	Ampullary mass	Ampullary cyst 35 mm × 30 mm with double wall and clear content	Nil	Duplication cyst	Endoscopic deroofing
5	15	F	Peri-gastric mass	Extraluminal cyst arising from the muscularis propria of antral wall with double wall about 40 mm × 35 mm	Nil	Duplication cyst	Follow up
6	18	M	Peri-gastric mass	Hypoechoic ill-defined peri-gastric collection with hyperechoic calcified areas	19G	Postpancreatitis collection	Resolved with antibiotics
7	17	M	Rectal SEL	Exophytic rectal mass about 33 mm × 21 mm mostly arising from the muscularis propria with intact submucosa and mucosa	19G	GIST	Surgery
8	18	M	Mediastinal mass	Large subcarinal cyst 10 cm × 7.6 cm compressing the right atrium and trachea with organized blood inside	19G	Bronchogenic cyst	Full aspiration by EUS with no recurrence
9	18	F	Mediastinal mass	Multiple hypoechoic subcarinal, para-aortic and celiac lymph nodes, largest about 22 mm	22G	Lymphoma	Chemotherapy
10	18	M	Abdominal lymphadenopathy	Multiple hypoechoic lymph nodes at portahepatis, para-aortic, and aorto-caval regions, largest about 55 mm × 34 mm. Splenomegaly with multiple focal lesions	22G	Lymphoma	Chemotherapy
11	18	F	Suspected insulinoma	Normal pancreas with no detected lesions	Nil	Nil	Nil
12	6	M	Suspected insulinoma	Normal pancreas with no detected lesions	Nil	Nil	Nil
13	17	F	Suspected insulinoma	Normal pancreas with no detected lesions	Nil	Nil	Nil

G: Gauge; SMA: Superior mesenteric artery; NET: Neuroendocrine tumor; SPN: Solid pseudopapillary neoplasm; SEL: Subepithelial lesion; GIST: Gastrointestinal stromal tumor; EUS-FNA: Endoscopic ultrasound-guided fine needle aspiration.

Table 3 Summary of current literature in comparison to our study

Ref.	Patients, n	EUS, n	Time frame (yr)	Age range (yr)	Pancreatobiliary indications	Other indications	EUS-FNA
Roseau et al[9], 1998	18	23	7	4-16	8	15	0
Varadarajulu et al[10], 2005	14	15	3	5-17	15	0	3
Cohen et al[5], 2008	32	32	6	1.5-18	19	13	7
Bjerring et al[11], 2008	18	18	16	0.5-15	11	7	0
Attila et al[8], 2009	38	40	7	3-17	25	15	12
Al-Rashdan et al[7], 2010	56	58	8	4-18	42	15	15
Rosen et al[12], 2010	25	42	5	NA	0	42	0
Scheers et al[4], 2015	48	52	14	2-17	52	0	12
Gordon et al[6], 2016	43	51	6	4-18	34	17	13
Mahajan et al[3], 2016	121	125	8	3-18	118	7	7
Fugazza et al[15], 2017	40	47	6	3-18	28	19	3
Raina et al[16], 2017	58	68	5	6-21	38	20	13
Current study	13	13	4	6-18	6	7	7
Total	524	584	3-16	0.5-21	396	177	92

NA: Not available; EUS: Endoscopic ultrasound; FNA: Fine needle aspiration.