CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2016; 07(03): 104-109
DOI: 10.4103/0976-5042.193738
Review Article
Journal of Digestive Endoscopy

Role of endoscopic ultrasound in pediatric gastrointestinal diseases

Rajiv Ranjan Singh
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Narendra Singh Choudhary
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Rajesh Puri
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
› Author Affiliations
Further Information

Publication History

Publication Date:
26 September 2019 (online)

Abstract

Endoscopic ultrasound (EUS) is a well-established diagnostic and therapeutic modality for adults. It is extremely helpful for a broad range of diagnostic indications including upper gastrointestinal (GI) malignancies, submucosal lesions, pancreatic lesions (masses, cystic lesions), chronic pancreatitis, etiological workup of recurrent acute pancreatitis, common bile duct evaluation (calculi versus tumor), gallbladder lesions/microliths, and rectal malignancy; well-established therapeutic roles include fine-needle aspiration of lesions/lymph nodes, pancreatic fluid collection drainage, pancreatic duct drainage, biliary drainage, gallbladder drainage, pelvic abscess drainage, celiac plexus block, or neurolysis. Some recent studies have reported the use of EUS in the pediatric population. EUS is safe and easy to perform in the pediatric population also. However, there is paucity of data on use of EUS in pediatric population. In contrast with its regular therapeutic use in adults, EUS is not commonly performed in children for therapeutic reasons and most of the data are available on diagnostic use only. All of studies have shown that EUS is safe and a useful modality with a positive impact on management in majority of study population. EUS is very useful in pediatric population for the evaluation of upper GI tract submucosal lesions or rectal masses, pancreaticobiliary disorders, characterization of esophageal strictures, and for evaluation of enteric duplication cysts. The advent of miniprobe that can be passed through conventional endoscopes has increased the applicability of EUS in infants and children. Although there are limited data regarding use of EUS in pediatric population, it appears to be a very promising diagnostic and therapeutic tool.

 
  • References

  • 1 DiMagno EP, Buxton JL, Regan PT, Hattery RR, Wilson DA, Suarez JR, et al. Ultrasonic endoscope. Lancet 1980;1:629-31.
  • 2 ASGE Technology Committee, Barth BA, Banerjee S, Bhat YM, Desilets DJ, Gottlieb KT, et al. Equipment for pediatric endoscopy. Gastrointest Endosc 2012;76:8-17.
  • 3 Varadarajulu S, Wilcox CM, Eloubeidi MA. Impact of EUS in the evaluation of pancreaticobiliary disorders in children. Gastrointest Endosc 2005;62:239-44.
  • 4 Cohen S, Kalinin M, Yaron A, Givony S, Reif S, Santo E. Endoscopic ultrasonography in pediatric patients with gastrointestinal disorders. J Pediatr Gastroenterol Nutr 2008;46:551-4.
  • 5 Bjerring OS, Durup J, Qvist N, Mortensen MB. Impact of upper gastrointestinal endoscopic ultrasound in children. J Pediatr Gastroenterol Nutr 2008;47:110-3.
  • 6 Attila T, Adler DG, Hilden K, Faigel DO. EUS in pediatric patients. Gastrointest Endosc 2009;70:892-8.
  • 7 Al-Rashdan A, LeBlanc J, Sherman S, McHenry L, DeWitt J, Al-Haddad M. Role of endoscopic ultrasound for evaluating gastrointestinal tract disorders in pediatrics: A tertiary care center experience. J Pediatr Gastroenterol Nutr 2010;51:718-22.
  • 8 Scheers I, Ergun M, Aouattah T, Piessevaux H, Borbath I, Stephenne X, et al. Diagnostic and therapeutic roles of endoscopic ultrasound in pediatric pancreaticobiliary disorders. J Pediatr Gastroenterol Nutr 2015;61:238-47.
  • 9 Mahajan R, Simon EG, Chacko A, Reddy DV, Kalyan PR, Joseph AJ, et al. Endoscopic ultrasonography in pediatric patients – Experience from a tertiary care center in India. Indian J Gastroenterol 2016;35:14-9.
  • 10 Kim E, Telford JJ. Endoscopic ultrasound advances, part 1: Diagnosis. Can J Gastroenterol 2009;23:594-601.
  • 11 ASGE Standards of Practice Committee, Gan SI, Rajan E, Adler DG, Baron TH, Anderson MA, et al. Role of EUS. Gastrointest Endosc 2007;66:425-34.
  • 12 Erickson RA. EUS-guided FNA. Gastrointest Endosc 2004;60:267-79.
  • 13 Kitano M, Sakamoto H, Matsui U, Ito Y, Maekawa K, von Schrenck T, et al. A novel perfusion imaging technique of the pancreas: Contrast-enhanced harmonic EUS (with video). Gastrointest Endosc 2008;67:141-50.
  • 14 Neff LP, Mishra G, Fortunato JE, Laudadio J, Petty JK. Microlithiasis, endoscopic ultrasound, and children: Not just little gallstones in little adults. J Pediatr Surg 2011;46:462-6.
  • 15 Laffan TA, Horton KM, Klein AP, Berlanstein B, Siegelman SS, Kawamoto S, et al. Prevalence of unsuspected pancreatic cysts on MDCT. AJR Am J Roentgenol 2008;191:802-7.
  • 16 Lee HJ, Kim MJ, Choi JY, Hong HS, Kim KA. Relative accuracy of CT and MRI in the differentiation of benign from malignant pancreatic cystic lesions. Clin Radiol 2011;66:315-21.
  • 17 Zhang XM, Mitchell DG, Dohke M, Holland GA, Parker L. Pancreatic cysts: Depiction on single-shot fast spin-echo MR images. Radiology 2002;223:547-53.
  • 18 Ramesh J, Bang JY, Trevino J, Varadarajulu S. Endoscopic ultrasound-guided drainage of pancreatic fluid collections in children. J Pediatr Gastroenterol Nutr 2013;56:30-5.
  • 19 De Angelis P, Romeo E, Rea F, Torroni F, Caldaro T, Federici di Abriola G, et al. Miniprobe EUS in management of pancreatic pseudocyst. World J Gastrointest Endosc 2013;5:255-60.
  • 20 Jazrawi SF, Barth BA, Sreenarasimhaiah J. Efficacy of endoscopic ultrasound-guided drainage of pancreatic pseudocysts in a pediatric population. Dig Dis Sci 2011;56:902-8.
  • 21 Sakorafas GH, Smyrniotis V, Reid-Lombardo KM, Sarr MG. Primary pancreatic cystic neoplasms revisited. Part III. Intraductal papillary mucinous neoplasms. Surg Oncol 2011;20:e109-18.
  • 22 Sakorafas GH, Smyrniotis V, Reid-Lombardo KM, Sarr MG. Primary pancreatic cystic neoplasms revisited: Part II. Mucinous cystic neoplasms. Surg Oncol 2011;20:e93-101.
  • 23 Sakorafas GH, Smyrniotis V, Reid-Lombardo KM, Sarr MG. Primary pancreatic cystic neoplasms revisited. Part I: Serous cystic neoplasms. Surg Oncol 2011;20:e84-92.
  • 24 Sakorafas GH, Smyrniotis V, Reid-Lombardo KM, Sarr MG. Primary pancreatic cystic neoplasms of the pancreas revisited. Part IV: Rare cystic neoplasms. Surg Oncol 2012;21:153-63.
  • 25 Brugge WR, Lewandrowski K, Lee-Lewandrowski E, Centeno BA, Szydlo T, Regan S, et al. Diagnosis of pancreatic cystic neoplasms: A report of the cooperative pancreatic cyst study. Gastroenterology 2004;126:1330-6.
  • 26 Michaels PJ, Brachtel EF, Bounds BC, Brugge WR, Pitman MB. Intraductal papillary mucinous neoplasm of the pancreas: Cytologic features predict histologic grade. Cancer 2006;108:163-73.
  • 27 Hutchins GF, Draganov PV. Cystic neoplasms of the pancreas: A diagnostic challenge. World J Gastroenterol 2009;15:48-54.
  • 28 Park WG, Mascarenhas R, Palaez-Luna M, Smyrk TC, O’Kane D, Clain JE, et al. Diagnostic performance of cyst fluid carcinoembryonic antigen and amylase in histologically confirmed pancreatic cysts. Pancreas 2011;40:42-5.
  • 29 Pitman MB, Michaels PJ, Deshpande V, Brugge WR, Bounds BC. Cytological and cyst fluid analysis of small (< or=3 cm) branch duct intraductal papillary mucinous neoplasms adds value to patient management decisions. Pancreatology 2008;8:277-84.
  • 30 Afify AM, al-Khafaji BM, Kim B, Scheiman JM. Endoscopic ultrasound-guided fine needle aspiration of the pancreas. Diagnostic utility and accuracy. Acta Cytol 2003;47:341-8.
  • 31 Harewood GC, Wiersema MJ. Endosonography-guided fine needle aspiration biopsy in the evaluation of pancreatic masses. Am J Gastroenterol 2002;97:1386-91.
  • 32 Eloubeidi MA, Chen VK, Eltoum IA, Jhala D, Chhieng DC, Jhala N, et al. Endoscopic ultrasound-guided fine needle aspiration biopsy of patients with suspected pancreatic cancer: Diagnostic accuracy and acute and 30-day complications. Am J Gastroenterol 2003;98:2663-8.
  • 33 Konishi Y, Nakamura T, Kida H, Seno H, Okazaki K, Chiba T. Catheter US probe EUS evaluation of gastric cardia and perigastric vascular structures to predict esophageal variceal recurrence. Gastrointest Endosc 2002;55:197-203.
  • 34 Lahoti S, Catalano MF, Alcocer E, Hogan WJ, Geenen JE. Obliteration of esophageal varices using EUS-guided sclerotherapy with color Doppler. Gastrointest Endosc 2000;51:331-3.
  • 35 Masalaite L, Valantinas J, Stanaitis J. Endoscopic ultrasound findings predict the recurrence of esophageal varices after endoscopic band ligation: A prospective cohort study. Scand J Gastroenterol 2015;50:1322-30.
  • 36 Choudhuri G, Dhiman RK, Agarwal DK. Endosonographic evaluation of the venous anatomy around the gastro-esophageal junction in patients with portal hypertension. Hepatogastroenterology 1996;43:1250-5.
  • 37 Hino S, Kakutani H, Ikeda K, Uchiyama Y, Sumiyama K, Kuramochi A, et al. Hemodynamic assessment of the left gastric vein in patients with esophageal varices with color Doppler EUS: Factors affecting development of esophageal varices. Gastrointest Endosc 2002;55:512-7.
  • 38 Kuramochi A, Imazu H, Kakutani H, Uchiyama Y, Hino S, Urashima M. Color Doppler endoscopic ultrasonography in identifying groups at a high-risk of recurrence of esophageal varices after endoscopic treatment. J Gastroenterol 2007;42:219-24.
  • 39 Romero-Castro R, Pellicer-Bautista FJ, Jimenez-Saenz M, Marcos-Sanchez F, Caunedo-Alvarez A, Ortiz-Moyano C, et al. EUS-guided injection of cyanoacrylate in perforating feeding veins in gastric varices: Results in 5 cases. Gastrointest Endosc 2007;66:402-7.
  • 40 Binmoeller KF, Weilert F, Shah JN, Kim J. EUS-guided transesophageal treatment of gastric fundal varices with combined coiling and cyanoacrylate glue injection (with videos). Gastrointest Endosc 2011;74:1019-25.
  • 41 Romero-Castro R, Ellrichmann M, Ortiz-Moyano C, Subtil-Inigo JC, Junquera-Florez F, Gornals JB, et al. EUS-guided coil versus cyanoacrylate therapy for the treatment of gastric varices: A multicenter study (with videos). Gastrointest Endosc 2013;78:711-21.
  • 42 Nihoul-Fékété C, De Backer A, Lortat-Jacob S, Pellerin D. Congenital esophageal stenosis. A review of 20 cases. Pediatr Surg Int 1987;2:86-92.
  • 43 Takamizawa S, Tsugawa C, Mouri N, Satoh S, Kanegawa K, Nishijima E, et al. Congenital esophageal stenosis: Therapeutic strategy based on etiology. J Pediatr Surg 2002;37:197-201.
  • 44 Michaud L, Coutenier F, Podevin G, Bonnard A, Becmeur F, Khen-Dunlop N, et al. Characteristics and management of congenital esophageal stenosis: Findings from a multicenter study. Orphanet J Rare Dis 2013;8:186.
  • 45 Romeo E, Foschia F, de Angelis P, Caldaro T, Federici di Abriola G, Gambitta R, et al. Endoscopic management of congenital esophageal stenosis. J Pediatr Surg 2011;46:838-41.
  • 46 Terui K, Saito T, Mitsunaga T, Nakata M, Yoshida H. Endoscopic management for congenital esophageal stenosis: A systematic review. World J Gastrointest Endosc 2015;7:183-91.
  • 47 Wildi SM, Hoda RS, Fickling W, Schmulewitz N, Varadarajulu S, Roberts SS, et al. Diagnosis of benign cysts of the mediastinum: The role and risks of EUS and FNA. Gastrointest Endosc 2003;58:362-8.
  • 48 Faigel DO, Burke A, Ginsberg GG, Stotland BR, Kadish SL, Kochman ML. The role of endoscopic ultrasound in the evaluation and management of foregut duplications. Gastrointest Endosc 1997;45:99-103.
  • 49 Eloubeidi MA, Cohn M, Cerfolio RJ, Chhieng DC, Jhala N, Jhala D, et al. Endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of foregut duplication cysts: the value of demonstrating detached ciliary tufts in cyst fluid. Cancer 2004;102:253-8.
  • 50 Romeo E, Torroni F, Foschia F, De Angelis P, Caldaro T, Santi MR, et al. Surgery or endoscopy to treat duodenal duplications in children. J Pediatr Surg 2011;46:874-8.
  • 51 Riyaz A, Cohen H. Ectopic pancreas presenting as a submucosal gastric antral tumor that was cystic on EUS. Gastrointest Endosc 2001;53:675-7.
  • 52 De Angelis P, Trecca A, Francalanci P, Torroni F, Federici Di Abriola G, Papadatou B, et al. Heterotopic gastric mucosa of the rectum. Endoscopy 2004;36:927.
  • 53 Fox VL, Nurko S, Teitelbaum JE, Badizadegan K, Furuta GT. High-resolution EUS in children with eosinophilic “allergic” esophagitis. Gastrointest Endosc 2003;57:30-6.
  • 54 Dalby K, Nielsen RG, Kruse-Andersen S, Fenger C, Durup J, Husby S. Gastroesophageal reflux disease and eosinophilic esophagitis in infants and children. A study of esophageal pH, multiple intraluminal impedance and endoscopic ultrasound. Scand J Gastroenterol 2010;45:1029-35.
  • 55 Kouchi K, Yoshida H, Matsunaga T, Ohtsuka Y, Nagatake E, Satoh Y, et al. Endosonographic evaluation in two children with esophageal stenosis. J Pediatr Surg 2002;37:934-6.
  • 56 Van Dam J. Endosonographic evaluation of the patient with achalasia. Endoscopy 1998;30 Suppl 1:A48-50.
  • 57 Ellrichmann M, Wietzke-Braun P, Dhar S, Nikolaus S, Arlt A, Bethge J, et al. Endoscopic ultrasound of the colon for the differentiation of Crohn’s disease and ulcerative colitis in comparison with healthy controls. Aliment Pharmacol Ther 2014;39:823-33.
  • 58 Higaki S, Nohara H, Saitoh Y, Akazawa A, Yanai H, Yoshida T, et al. Increased rectal wall thickness may predict relapse in ulcerative colitis: A pilot follow-up study by ultrasonographic colonoscopy. Endoscopy 2002;34:212-9.
  • 59 Lew RJ, Ginsberg GG. The role of endoscopic ultrasound in inflammatory bowel disease. Gastrointest Endosc Clin N Am 2002;12:561-71.
  • 60 Rosen MJ, Moulton DE, Koyama T, Morgan WM 3rd, Morrow SE, Herline AJ, et al. Endoscopic ultrasound to guide the combined medical and surgical management of pediatric perianal Crohn’s disease. Inflamm Bowel Dis 2010;16:461-8.