소아청소년에서 주증상에 기초한 대장 내시경 검사의 진단적 성과분석
Diagnostic Yield of Pediatric Colonoscopies Based on Presenting Symptoms in a Secondary Hospital
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Purpose: We performed this study retrospectively to review the diagnostic yield of colonoscopies in children and adolescents with various gastrointestinal symptoms and to investigate the relationship between presenting symptoms and the colonoscopic findings in a secondary hospital. Methods: We reviewed the medical records of patients under the age of 19-years who underwent ileocolonoscopy between January 2001 and December 2010. The total number of patients (n=238) were divided into three age groups and six symptom groups. We analyzed clinical characteristics and the colonoscopic findings, and compared the colonoscopic yield between each groups. Results: The median age of the patients was 16.1 (3.1∼18.9) years. The most common presenting symptoms were lower gastrointestinal (GI) bleeding (48.1%) in the ≤12 years group (n=27), chronic abdominal pain (31.8%) in the 13∼15 years group (n=85), and chronic diarrhea (34.9%) in the ≥16 years group (n=126). Positive colonoscopic findings were found in 21.4% of the bowel habit change group (n=28), 51.9% of the low GI bleeding group (n=54), 37.7% of the chronic diarrhea group (n=69), and 94.4% of the group with suspected inflammatory bowel disease (IBD) (n=18), 38.9% of the chronic abdominal pain group (n=54) and 13.3% of the anemia group (n=15). The diagnostic yield of the total examination was 42.0%. The suspected IBD group had a higher yield than the presenting symptom groups (p＜0.001). Conclusion: Colonoscopy is a safe and useful investigation in children and adolescents with suspected colonic disease. The diagnostic yield of colonoscopy is higher in patients presenting with suspected IBD. Pediatricians practicing in primary or secondary care settings should recommend colonoscopy for patients with suspected IBD. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 368∼375)
Abstract
Purpose: We performed this study retrospectively to review the diagnostic yield of colonoscopies in children and adolescents with various gastrointestinal symptoms and to investigate the relationship between presenting symptoms and the colonoscopic findings in a secondary hospital. Methods: We reviewed the medical records of patients under the age of 19-years who underwent ileocolonoscopy between January 2001 and December 2010. The total number of patients (n=238) were divided into three age groups and six symptom groups. We analyzed clinical characteristics and the colonoscopic findings, and compared the colonoscopic yield between each groups. Results: The median age of the patients was 16.1 (3.1∼18.9) years. The most common presenting symptoms were lower gastrointestinal (GI) bleeding (48.1%) in the ≤12 years group (n=27), chronic abdominal pain (31.8%) in the 13∼15 years group (n=85), and chronic diarrhea (34.9%) in the ≥16 years group (n=126). Positive colonoscopic findings were found in 21.4% of the bowel habit change group (n=28), 51.9% of the low GI bleeding group (n=54), 37.7% of the chronic diarrhea group (n=69), and 94.4% of the group with suspected inflammatory bowel disease (IBD) (n=18), 38.9% of the chronic abdominal pain group (n=54) and 13.3% of the anemia group (n=15). The diagnostic yield of the total examination was 42.0%. The suspected IBD group had a higher yield than the presenting symptom groups (p＜0.001). Conclusion: Colonoscopy is a safe and useful investigation in children and adolescents with suspected colonic disease. The diagnostic yield of colonoscopy is higher in patients presenting with suspected IBD. Pediatricians practicing in primary or secondary care settings should recommend colonoscopy for patients with suspected IBD. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 368∼375)
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