Pediatric Endoscopy An Issue Of Gastrointestinal Endoscopy Clinics Of North America

Over a short few decades, the field of pediatric endoscopy has matured from the exploratory to the routine. Performance of endoscopic procedures in children is now a fundamental aspect of the practice of more than 2000 pediatric gastroenterologists in North America, and endoscopic instruments are increasingly being developed with an eye to their pediatric applications. Ensuring safe and effective endoscopy in children requires specific medical knowledge and technical competency, in addition to appropriately designed equipment and settings. Obtaining consent from parents, as well as assent from patients, for the purposes of performing diagnostic and therapeutic gastrointestinal procedures begins with a deep understanding of risks and benefits that endoscopy affords and is typically gained through formal training in the field. Diagnostic endoscopy may help to confirm common pediatric conditions including eosinophilic esophagitis and inflammatory bowel disease, while therapeutic procedures to treat strictures in the GI tract may help children avoid more invasive surgeries. Using endoscopy in children to achieve hemostasis or to remove commonly swallowed foreign bodies, such as lithium batteries or high-powered magnets, can be lifesaving, and the insertion of feeding tubes can help medically complex patients to thrive. In short, pediatric endoscopy is an integral component of healthcare for children, and gaining and understanding of its best practices may help all clinicians to better recognize its role in pediatric disease outcomes.

In this issue of Gastrointestinal Endoscopy Clinics of North America, guest editor Dr. Catharine M. Walsh brings her considerable expertise to the topic of Pediatric Endoscopy. Since its inception in the early 1980s, pediatric endoscopy has seen dramatic innovations in both diagnostic procedures and advanced procedures that are increasingly being performed by pediatric trained endoscopists. In this issue, top experts bring you fully up to date with recent advances in this fast-changing field. Contains 14 practice-oriented topics including pediatric unsedated transnasal endoscopy; tools for improving quality in pediatric endoscopy; artificial intelligence in pediatric endoscopy; advances in endoscopy for pediatric inflammatory bowel disease; and more. Provides in-depth clinical reviews on pediatric endoscopy, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

In this issue of Gastrointestinal Endoscopy Clinics of North America, guest editor Dr. Catharine M. Walsh brings her considerable expertise to the topic of Pediatric Endoscopy. Since its inception in the early 1980s, pediatric endoscopy has seen dramatic innovations in both diagnostic procedures and advanced procedures that are increasingly being performed by pediatric trained endoscopists. In this issue, top experts bring you fully up to date with recent advances in this fast-changing field. Contains 14 practice-oriented topics including pediatric unsedated transnasal endoscopy; tools for improving quality in pediatric endoscopy; artificial intelligence in pediatric endoscopy; advances in endoscopy for pediatric inflammatory bowel disease; and more. Provides in-depth clinical reviews on pediatric endoscopy, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

In this issue an impressive group of contributors at the forefront of sedation research has been assembled to provide endoscopists and dedicated nursing personnel alike a comprehensive review of important topics in the field sedation and analgesia. A discussion on the pharmacology and agents used to provide moderate and deep sedation provides the basic framework that is a crucial element in determining the driving force behind the developments in sedation and analgesia. An evidence-based approach on the use of unsedated endoscopy is also provided. Other topics included the use of propofol, patient-controlled sedation and analgesia, extended physiologic monitoring, risk management, and quality assurance as they apply to the spectrum of sedation in the endoscopy suite. Sedation and analgesia in the pediatric patient is also addressed.

There is a broad spectrum of clinical problems that demand urgent attention and intervention by gastroenterologists. With recent expansion of armamentarium of devices and techniques for therapeutic endoscopy, there has been significant evolution of practices in this area. The focus of this issue will be on the endoscopic aspects of these emergencies, but will include clinical evaluation, and related medical and surgical management as well. We have assembled a world-class group of authors with expertise in individual areas. Dr Peter Stevens will cover triage and endoscopic management of acute nonvariceal hemorrhage, with emphasis on newer techniques of endoscopic hemostasis including clips as well as traditional thermal and injection therapies. Dr Arun Sanyal will review the medical and therapeutic endoscopic aspects of portal hypertensive bleeding. Dr Brenna Bounds will detail the emerging techniques and current approach to acute lower GI hemorrhage, including role of urgent colonoscopy, and adaptation of newer techniques for endoscopic hemostasis including clips and band ligation. Dr Todd Baron will cover management of acute colonic obstruction with particular emphasis on placement of colonic stents. Dr Michael Saunders will discuss medical and endoscopic management of colonic pseudoobstruction with emphasis on medical management of role of colonoscopic decompression. In the area of pancreaticobiliary emergencies, the role of endoscopic intervention for acute biliary and other forms of pancreatitis will be detailed by Dr Paul Tarnasky. Acute cholangitis and the role of ERCP will be discussed by Dr Tim Kinney. Dr XX (works with Dr Roy Wong) will discuss management of foreign body and food impaction, with emphasis on some of the newer devices and overtubes to facilitate safe extraction. Dr David Greenwald will cover the management of endoscopically-induced complications such as bleeding and perforation. Finally, the particulars of the pediatric approach to endoscopic emergencies in children and infants, and the approach to caustic ingestions will be reviewed by Dr Khalid Khan.

The topics covered in this issue, an update from what was first published in the Gastrointestinal Endoscopy Clinics in 2008, reflect the fact that NOTES is seeing a resurgence in popularity. Now, eight years later, there is more data to confirm safety, to look at the best options for using natural orifices, and to talk about optimal training scenarios. The Guest Editor has enlisted some of the top experts on NOTES to contribute articles devoted to Seminal Developments: SM Tunnel Technique; Peroral Endoscopic Myotomoy (POEM); Submucosal Tumor Endoscopic Resection; Endoscopic Full Thickness Resection; Submucosal Tunneling for NOTES Procedures Beyond Resection; Pyloromyotomy; New NOTES: Western Perspective; and Why Did the Old NOTES Fail: Lessons Learned that can Guide New NOTES Development.

The Guest Editors have tapped top key opinion leaders to provide current reviews on the clinical diagnosis and treatment of gastrointestinal disease in children. They have focused on topics related to GERD; Celiac Disease and Gluten Sensitivity; IBD; Motility Disorders; GI Bleeding and Management; Pancreatic Disorders; Hepatitis B and C; Liver Transplant; Abdominal Pain; Complications from Obesity; and Neonatal Cholestasis.These articles will provide a state-of-the-art overview of diagnosis and treatment of GI diseases that are impactful for the general pediatrician.

In this issue of Gastrointestinal Endoscopy Clinics of North America, guest editor Dr. Amrita Sethi brings her considerable expertise to the topic of Submucosal and Third Space Endoscopy. Endoscopic submucosal dissection (ESD) is now recognized as one of the preferred treatment modalities for premalignant gastrointestinal epithelial lesions and early gastric cancer without lymph node metastasis. ESD techniques require advanced skills, and this issue brings together top experts in the field who provide the information endoscopists need to improve these skills. Contains 15 practice-oriented topics including building the toolbox of devices to optimize a practice in submucosal endoscopy; understanding the principles of electrocautery for submucosal endoscopy; endoscopic submucosal dissection in the colon and rectum; techniques for peroral endoscopic myotomy, from mouth to anus; management of adverse events of submucosal endoscopy; and more. Provides in-depth clinical reviews on submucosal and third space endoscopy, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.