Screening Endoscopy Contributes to Relevant Modifications of Therapeutic Regimen in Children with Intestinal Failure

Objective: The role of endoscopy in the diagnostic work-up of children with intestinal failure (IF) is not well defined. It is unclear whether endoscopies should be performed as a screening procedure or only upon manifestation of symptoms. The aim of this study is to evaluate, whether performing screening endoscopy contributes to clinical management in children with IF. Methods: Comparative retrospective case-series study in children with IF (mean age 70,4 months ± 58,4 months) presenting for diagnostic work-up in a single intestinal rehabilitation center. Endoscopies were performed either as a screening procedure (Group 1, n = 45) or as indicated by symptoms of gastrointestinal dysfunction (Group 2, n = 11). Results: A total of 92 endoscopies (56 esophagogastroduodenoscopies; 12 enteroscopies; 24 colonoscopies) were performed in 56 children. IF etiology included short bowel syndrome (n = 37), motility disorder (n = 16) and mucosal enteropathy (n = 3). Comparing Group 1 with Group 2 abnormal endoscopic findings were detected in 66,7 % vs. 81,8 %. Findings led to adaptation of therapeutic regimes in 64,7 % vs. 85,7 %. We detected a higher rate of erosive and ulcerative gastritis and duodenitis, enteritis and colitis in Group 1 compared to Group 2. Conclusion: Endoscopy in children with IF frequently reveals abnormal findings, leading to recommendations for treatment adaptation in the majority of cases, irrespective of whether endoscopy has been performed as a screening procedure or as indicated by symptoms. Using endoscopy as a screening tool may improve both, the detection of gastrointestinal pathology and the clinical management of children with IF. Address correspondence and reprint requests to Andreas Busch, MD, University Children's Hospital Tübingen, Pediatric Gastroenterology and Hepatology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany (e-mail: andreas.busch@med.uni-tuebingen.de). Received 22 November, 2017 Accepted 26 April, 2018 Disclosure: The authors have no conflicts of interest to disclose Funding support: None © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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