Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2020; 12(10): 355-364
Published online Oct 16, 2020. doi: 10.4253/wjge.v12.i10.355
Role of endoscopic ultrasound in pediatric patients: A single tertiary center experience and review of the literature
Ahmed Youssef Altonbary, Hazem Hakim, Wagdi Elkashef
Ahmed Youssef Altonbary, Hazem Hakim, Department of Gastroenterology and Hepatology, Mansoura Specialized Medical Hospital, Mansoura University, Mansoura 35516, Egypt
Wagdi Elkashef, Department of Pathology, Mansoura University, Mansoura 35111, Egypt
Author contributions: Altonbary AY, Hakim H, Elkashef W contributed equally to this work; Altonbary AY contributed to the writing of the manuscript; Hakim H contributed to data collection and Elkashef W contributed to histopathological examination.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board at MedImmune and Gubra.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ahmed Youssef Altonbary, MD, Lecturer, Department of Gastroenterology and Hepatology, Mansoura Specialized Medical Hospital, Mansoura University, Mansoura 35516, Egypt.
Received: May 6, 2020
Peer-review started: May 6, 2020
First decision: May 15, 2020
Revised: May 18, 2020
Accepted: August 16, 2020
Article in press: August 16, 2020
Published online: October 16, 2020
Processing time: 161 Days and 3.9 Hours
Research background

Although endoscopic ultrasound (EUS) is now widely available and has an established role in adults, the utility of EUS and EUS-guided fine needle aspiration (EUS-FNA) in pediatrics is insufficiently described compared to adults and is only supported by a few studies.

Research motivation

More effort is necessary to increase the awareness of EUS among pediatric gastroenterologists, as it may have a clinical impact on the subsequent management and minimize unnecessary procedures in children.

Research objectives

The aim of this study was to report the experience of a single tertiary center in the use of EUS and EUS-FNA in a pediatric population and to further assess its safety, feasibility, and clinical impact on the subsequent management.

Research methods

This was a retrospective study. The patient’s medical records were reviewed for standard data which included patient demographics, initial diagnosis, previous abdominal ultrasound, computed tomography, or magnetic resonance imaging, EUS indications, EUS findings, impact of EUS on the patient’s clinical care, and adverse events.

Research results

During the 4-year study period, a total of 13 (1.7%) pediatric EUS examinations out of 749 EUS procedures were performed in our unit. The mean age of the 8 females and 5 males was 15.6 years (range: 6-18). Most of EUS examinations were pancreatobiliary. Overall, EUS-FNA was performed in 7 patients (53.8%) with a diagnostic yield of 100%. EUS had a significant impact on clinical care in 10/13 (77%) cases. No complications occurred in our patients during or after any of the procedures.

Research conclusions

EUS and EUS-FNA in the pediatric population are safe, feasible, and have a significant clinical impact on subsequent management; thus avoiding more invasive and additional unnecessary procedures.

Research perspectives

EUS utilization in pediatrics although rare, is expected to increase in the future. Dedicated EUS programs in high volume tertiary centers can ensure that the correct indications are followed, with a high impact on patient management and safety of procedures in the pediatric population.