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Paediatric Endoscopy (OGD) and Colonoscopy Outcome

COMPLICATION RATE (PERFORATION/BLEEDING) FROM GI SCOPE:

Upper Gastrointestinal (GI) endoscopy and colonoscopy are important procedures for the diagnosis and management of paediatric gastrointestinal problems. Although generally considered a safe procedure, endoscopy carries risks of perforation, bleeding and infection.

The Department of Paediatric Gastroenterology at KKH performs the largest number of paediatric endoscopies in Singapore. Over the last 3 years from 2012-2014, our department have performed close to 500 Upper GI Endoscopy and 300 Colonoscopy. The age range of patients is from infants less than 6 months old to 20 year old patients.

The procedures take place in the operating theatre with a senior paediatric anaesthetist giving deep sedation or general anaesthesia. We are one of few endoscopy centres in South East Asia whereby a paediatric anaesthetist is present throughout the procedure to ensure adequate sedation and to manage any potential cardiovascular or respiratory complications.

We have no complications of perforation and bleeding from our diagnostic Upper GI endoscopy and colonoscopy over the last 3 years. A review of the international literature quoted a perforation rate of 0.03% 1 for upper GI endoscopy and a perforation rate of 0.1-0.3% for diagnostic colonoscopy 2. Complication of significant bleeding occurs in 0.1-0.6% for colonoscopy 2 and is extremely low for upper GI endoscopy.

The number of procedures performed in our department is increasing on a year to year basis due to the increased number of patients seen in our outpatient clinics and inpatient services. We also have referral for international patients from around South East Asia and other parts of the world. We have maintained an extremely low endoscopy complication rate comparable to international figures.

References:

(1) Complications of upper GI endoscopy American Society for Gastrointestinal Endoscopy: Gastrointest Endosc 2002 55 (7) 784

(2) ASGE Standards of Practice Committee, Fisher DA, Maple JT, Ben-Menachem T et al Complications of colonoscopy. Gastrointest Endosc. 2011 Oct;74(4):745-52.