ERCP in the evaluation of abdominal pain in children. Gastrointest Endosc 2008 Dec;68(6):1081-5
Date
07/22/2008Pubmed ID
18640674DOI
10.1016/j.gie.2008.04.029Scopus ID
2-s2.0-56649086747 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
BACKGROUND: ERCP is feasible and safe in the pediatric population. Its utility in the evaluation of children with pain suggestive of a pancreatobiliary origin without objective findings compared with those with abnormal biochemical and/or imaging studies is not well known.
OBJECTIVE: To determine the utility of ERCP in the diagnosis and management of children seen with abdominal pain.
DESIGN: Retrospective review.
SETTING: One tertiary center.
PATIENTS: All children who underwent ERCP at one tertiary center from 1994 to 2004.
METHOD: An endoscopy database was used. Data sets with regard to indications, technical success, complications, and outcomes were evaluated. Before ERCP, children with abdominal pain were categorized into 2 groups: group I, those with objective findings, namely abnormal biochemistry and/or abnormal imaging studies; group II, those who had abdominal pain without objective findings.
MAIN OUTCOME MEASUREMENTS: ERCP success and failure rates, findings, interventions, complications, and outcomes were determined. Data were compared between group I and group II.
RESULTS: A total of 185 consecutive children with abdominal pain who underwent ERCP were identified (131 in group I and 54 in group II). ERCP technical success was achieved in 98%. In group I, ERCP identified a cause for abdominal pain in 93 of 129 children (72%). Fifty-four of 93 patients (58%) in this group underwent endoscopic intervention with resolution of pain. In group II, a cause for abdominal pain was identified in 30 of 53 children (56%)(P < .025 compared with group I). Fourteen of 30 patients (47%) in this group underwent endoscopic intervention with resolution of pain. Complications noted were mild pancreatitis in two and self-limited bleeding in one.
LIMITATIONS: A retrospective study, one tertiary center where the majority of the ERCPs were performed by one experienced operator.
CONCLUSIONS: ERCP in children with abdominal pain suggestive of a pancreatobiliary origin has a favorable risk:benefit ratio.
Author List
Dua K, Miranda A, Santharam R, Ramanujam S, Werlin SAuthors
Kulwinder S. Dua MD Professor in the Medicine department at Medical College of WisconsinAdrian Miranda MD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Abdominal PainAdolescent
Bile Duct Diseases
Child
Child, Preschool
Cholangiopancreatography, Endoscopic Retrograde
Female
Humans
Infant
Male
Pancreatic Diseases
Retrospective Studies
