The evolution of endoscopic reporting tools and practices maintains a high standard of reliability and consistency. The roles of endoscopic ultrasonography, capsule endoscopy, and deep enteroscopy in the management of IBD in pediatric and adolescent patients are gaining greater clarity. Exploration of endoscopic interventions, including balloon dilation and electroincision, is warranted in the context of pediatric inflammatory bowel disease (IBD), demanding further investigation. A discussion of the current use of endoscopic evaluation in pediatric inflammatory bowel disease is presented, encompassing the emerging and evolving strategies aimed at improving patient outcomes.

Advances in small bowel imaging, along with the introduction of capsule endoscopy, have dramatically reshaped the assessment of the small bowel, providing a trustworthy and non-invasive means for evaluating the mucosal surface. In cases of small bowel pathologies that conventional endoscopy cannot reach, device-assisted enteroscopy is essential for providing both histopathological confirmation and enabling endoscopic treatment procedures. This review comprehensively examines the indications, techniques, and clinical uses of capsule endoscopy, device-assisted enteroscopy, and imaging procedures for evaluating the small bowel in children.

The occurrence of upper gastrointestinal bleeding (UGIB) in children is impacted by a spectrum of causative factors, exhibiting variations in prevalence across different age groups. Hematemesis or melena often necessitate immediate patient stabilization, including airway management, fluid replenishment, and a transfusion target hemoglobin of 7 g/L. Endoscopy for bleeding lesions should focus on therapeutic combinations, usually integrating epinephrine injection alongside either cautery, hemoclips, or hemospray. anti-tumor immunity Recent advances in the diagnosis and management of variceal and non-variceal gastrointestinal bleeding in children, with particular attention to novel therapies for severe upper gastrointestinal bleeding, are presented in this review.

Pediatric neurogastroenterology and motility (PNGM) disorders, a prevalent and often debilitating condition, which remain challenging to diagnose and treat, have nevertheless seen remarkable progress over the last ten years. Gastrointestinal endoscopy, a valuable tool, has proven crucial for both the diagnosis and treatment of PNGM disorders. Improvements in PNGM diagnostics and therapeutics have resulted from the implementation of novel methods, including functional lumen imaging probes, per-oral endoscopic myotomy, gastric-POEM, and electrocautery incisional therapy. The review explores the increasing significance of endoscopic procedures for diagnosis and treatment of diseases of the esophagus, stomach, small bowel, colon, rectum, and anus, specifically touching on conditions related to the gut-brain axis interaction.

There is a notable increase in the prevalence of pancreatic disease among children and adolescents. Pancreatic diseases in adults often require the integration of interventional endoscopic procedures, including endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography, for effective diagnosis and management. Ten years ago, pediatric interventional endoscopic procedures were less accessible, but now they are more widespread, replacing invasive surgical procedures with safer, less disruptive endoscopic techniques.

Congenital esophageal defects necessitate the critical involvement of the endoscopist in patient management. medical psychology An endoscopic approach to the management of comorbidities arising from esophageal atresia and congenital esophageal strictures, including anastomotic strictures, tracheoesophageal fistulas, esophageal perforations, and esophagitis surveillance, is the subject of this review. Endoscopic stricture management is reviewed in practice, examining techniques such as dilation, intralesional steroid injection, stenting, and endoscopic incisional therapies. To prevent the development of esophagitis and its potentially life-altering complications, such as Barrett's esophagus, careful endoscopic monitoring of mucosal conditions is imperative for this patient group.

Diagnosing and monitoring eosinophilic esophagitis (EoE), a chronic, allergen-mediated clinicopathologic condition, presently requires esophagogastroduodenoscopy, biopsy collection, and histologic assessment. In this in-depth review, the pathophysiology of EoE is investigated, the use of endoscopy as both a diagnostic and a therapeutic tool is assessed, and the potential for complications from therapeutic endoscopic interventions is analyzed. Endoscopist's capabilities in diagnosing and monitoring EoE are further strengthened through the incorporation of recent innovations, leading to a safer and more effective approach to therapeutic procedures using minimally invasive techniques.

A feasible, safe, and cost-effective approach for pediatric patients is unsedated transnasal endoscopy (TNE). Esophageal visualization via TNE enables the acquisition of biopsy samples, eliminating the risks associated with sedation and anesthesia procedures. In assessing and tracking upper gastrointestinal tract ailments, especially diseases like eosinophilic esophagitis demanding repeated endoscopic examinations, TNE should be a key consideration. Establishing a TNE program necessitates a comprehensive business plan, coupled with staff and endoscopist training.

Pediatric endoscopy stands to benefit greatly from the implementation of artificial intelligence. A majority of preclinical studies, performed on adults, have seen the most notable progress in the context of colorectal cancer screening and surveillance protocols. Deep learning, particularly the convolutional neural network model, is the key enabler of this development, providing the capability for real-time pathology detection. Deep learning models, in relation to inflammatory bowel disease, largely concentrated on predicting disease severity using still images, in contrast to employing video data. The use of AI in pediatric endoscopy is currently in its initial phase, affording the chance to construct clinically valuable and unbiased systems that do not replicate societal inequities. The current review delves into artificial intelligence, surveying its advancements in endoscopy, and considering its potential uses in pediatric endoscopic training and clinical applications.

Quality improvement standards and indicators for pediatric endoscopy procedures have been developed by the founding working group of the international Pediatric Endoscopy Quality Improvement Network (PEnQuIN). Real-time capture of quality indicators is achievable using existing electronic medical record (EMR) functionalities, enabling continuous quality measurement and enhancement within pediatric endoscopy settings. Cross-institutional data sharing, facilitated by EMR interoperability, serves to validate PEnQuIN standards of care, enabling benchmarking across endoscopy services and raising the quality of pediatric endoscopic care globally.

Acquiring ileocolonoscopy skills represents a vital component of pediatric endoscopic practice, facilitating the development of additional expertise through educational initiatives and specialized training, thus enhancing patient care and outcomes. The emergence of new technologies is driving the ongoing development of endoscopy. Devices are readily available to boost both the quality and ergonomic aspects of endoscopy procedures. Dynamic adjustments of position are techniques that can improve procedural efficiency and completeness. A training strategy that addresses cognitive, technical, and non-technical skill development is essential for upskilling endoscopists, further complemented by the crucial training-the-trainer approach to ensuring effective endoscopy education. This chapter explores the facets of enhancing pediatric ileocolonoscopy skills.

Pediatric endoscopists, continually engaging in endoscopy procedures, are vulnerable to work-related injuries arising from repetitive motions and overuse. There has recently been a growing emphasis on ergonomic education and training to build long-term injury-prevention routines, thereby promoting safety and well-being. This paper analyzes the incidence of endoscopy-related injuries among pediatric patients, describes methods for controlling workplace exposures, discusses fundamental ergonomic principles to minimize injury potential, and details how to effectively integrate endoscopic ergonomics education into training.

Sedation for pediatric endoscopic procedures has progressed from an endoscopist-provided component to a nearly exclusive responsibility of anesthesiologists. Although no ideal protocols govern the sedation process, whether performed by endoscopists or anesthesiologists, notable discrepancies exist in practice methodologies for both. Sedation used for pediatric endoscopy procedures, irrespective of whether it's administered by endoscopists or anesthesiologists, remains the most significant risk to patient safety. To guarantee patient safety, improve procedural efficacy, and decrease expenses, the best sedation practices must be determined jointly by both specialties. This review examines specific sedation levels for endoscopy, exploring the risks and benefits of different treatment protocols.

In the realm of cardiomyopathy, nonischemic types are frequently encountered. Selleck Temsirolimus The development of knowledge about the mechanisms and triggers of these cardiomyopathies has led to the betterment and even the complete restoration of the left ventricular function. While chronic right ventricular pacing-induced cardiomyopathy has long been acknowledged, recent research highlights left bundle branch block and pre-excitation as potentially reversible causes of cardiomyopathy. The abnormal ventricular propagation exhibited by these cardiomyopathies is discernible by a wide QRS duration, mimicking a left bundle branch block pattern, prompting the term abnormal conduction-induced cardiomyopathies. Such aberrant propagation of electrical signals causes a non-standard contractility pattern, visible only through cardiac imaging as ventricular dyssynchrony.