Paediatric Gastrointestinal Endoscopy | KK Women's and Children's Hospital

Our experts in paediatric gastroenterology specialise in the diagnosis, management and treatment of an array of nutritional, gastrointestinal and liver disorders in infants, children and adolescents.

Our Services:

Gastroenterology Clinic
- Recurrent abdominal pain
- Peptic ulcer disease
- Prolonged Neonatal Jaundice
- Chronic constipation
- Intestinal motility disorder
- Malabsorption Syndromes
- Chronic Diarrhoea
- Gastroesophageal Reflux Disease
- Inflammatory bowel disease
- Food allergy
Liver Clinic - Any liver disease including
- Biliary Atresia
- Metabolic Liver Disease
- Hepatitis B / C
- Autoimmune liver disease
- Chronic liver failure
- Gallstones
- Recurrent and chronic pancreatitis
Feeding Clinic
- Swallowing Dysfunction
- Failure to thrive
- Feeding difficulties
Endoscopy
- Upper Gastrointestinal (GI) endoscopy and ileocolonoscopy, diagnostic and therapeutic
24-hour oesophageal pH monitoring and Impedance studies
Liver biopsy
Urea breath test, hydrogen breath test

The Paediatric Gastroenterology, Hepatology and Nutrition Service at KKH performs the largest number of paediatric endoscopies in Singapore. Our department performs approximately 250 upper GI endoscopies and 150 colonoscopies annually, for both diagnostic and therapeutic purposes. Therapeutic procedures performed include polypectomy, emergency GI bleed haemostatic therapy, foreign bodies retrieval, endoscopic therapy for oesophageal strictures (Table 1)

We are one of the 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 are consistently meeting the targets set for high-quality paediatric ileocolonoscopy (Table 2).

Although generally considered a safe procedure, endoscopy carries risks of perforation, bleeding and infection. The rate of complications in our department stand at 0% - 0.05%. A review of the international literature quoted the incidence of perforation during endoscopy to be from 0.06% to 0.3% (1). Bleeding risk of OGD in children has been reported to be 0.3% (2). For colonoscopies, a 0.43% rate of bleeding has been reported (3). We have maintained an extremely low endoscopy complication rate comparable to international figures.

Table 1: Average annual procedures numbers (from 2018 to 2024):

Upper GI endoscopy	250
Ileocolonoscopic	150
Therapeutic procedures: Varices endoscopic theraphy/other GI bleeding endoscopic theraphy/polypectomies	25 to 30
Wireless video capsule endoscopies	5 to 10

Table 2: Targets for endoscopy:

	KKH (avg between 2018 to 2024)	Target⁽⁴⁾
Caecal intubation	98.3%	≥90%
Terminal ileal intubation	95.8%	≥85%
Duodenal intubation	100%	≥95%

In KKH, we are meeting the targets set for high-quality paediatric gastrointestinal endoscopy, with a low complication rate.

References:
(1) Friedt M, Welsch S. An update on pediatric endoscopy. Eur J Med Res. 2013 Jul 25;18(1):24.
(2) Thakkar K, El-Serag HB, Mattek N, Gilger MA. Complications of pediatric EGD: a 4-year experience in PEDS-CORI. Gastrointest Endosc. 2007 Feb;65(2):213-21.
(3) Thakkar K, El-Serag HB, Mattek N, Gilger M. Complications of pediatric colonoscopy: a five-year multicenter experience. Clin Gastroenterol Hepatol. 2008 May;6(5):515-20.
(4) Walsh CM, Lightdale JR, Leibowitz IH, et al. Pediatric Endoscopy Quality Improvement Network Quality Standards and Indicators for Pediatric Endoscopists and Endoscopists in Training: A Joint NASPGHAN/ESPGHAN Guideline. J Pediatr Gastroenterol Nutr. 2022;74(S1 Suppl 1):S44