Advances in Clinical and Experimental Medicine
2019, vol. 28, nr 12, December, p. 1627–1632
Publication type: original article
New colon anatomy-related ratios used to predict the course of colonoscopy in children
1 Department of Human Morphology and Embryology, Division of Anatomy, Wroclaw Medical University, Poland
2 2nd Department and Clinic of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Poland
3 Department of Gastroenterology, Hepatology and Immunology. The Children’s Memorial Health Institute, Warszawa, Poland
4 Department of Hematology, Institute of Hematology and Transfusion Medicine, Warszawa, Poland
Background. In children, colonoscopy is a safe procedure, although it is more difficult to perform in patients whose body mass index (BMI) is under 25.
Objectives. The aim of the study was to establish the relationship between children’s age, body mass and height and incomplete colonoscopies due to colon anatomy.
Material and Methods. A retrospective evaluation of diagnostic endoscopies in 403 children aged 3–18 years (192 girls and 211 boys) was performed. New ratios were introduced: the incomplete colonoscopy anatomy-related ratio (ICAR) and the modified incomplete colonoscopy anatomy-related ratio (MICAR).
Results. The terminal ilium was not reached in 59 children: 27 girls and 32 boys (14.6% of patients). In 13 girls and 18 boys (comprising 7.69% of the study population) no pathological causes were found for the incomplete colonoscopy. There were statistically significant differences concerning colon anatomy-related incomplete colonoscopies in relation to the children’s weight. No significance was found in relation to height or age. Incomplete examinations were more frequent in patients weighing less than 30 kg (p = 0.0006), both in boys (p = 0.0090) and girls (p = 0.048). The risk of incomplete colonoscopy (odds ratio – OR) in boys and girls weighing less than 30 kg was 3.995 (95% CI = 1.489–10.720) and 3.373 (95% CI = 1.078–10.560), respectively. For this group of patients, the ICAR ranged between 0.0309 and 0.1889, while the MICAR range was 0.0–0.1889.
Conclusion. Body mass is a statistically significant factor for evaluating the risk of incomplete colonoscopies in children. The lower the ICAR and MICAR values, the lower the risk of non-completion of a colonoscopy due to anatomical (i.e., disease-unrelated) causes.
pediatric colonoscopy, incomplete colonoscopy, colon anatomy-related incomplete colonoscopy
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