LAUSR

OBJECTIVES The indications, diagnostic yield, complications and cecal and ileal intubation rates (CIR and IIR) for colonoscopies in children aged < 6 years, denoted pre-schoolers, is unclear since there is limited information for this group. We aimed to describe the above parameters in our cohort of pre-schoolers undergoing a colonoscopy. METHODS Retrospective review of all colonoscopies in a tertiary pediatric hospital between Dec 1, 2014 to Dec 31, 2020 was undertaken. Demographic factors, indication for colonoscopy, extent of colonoscopy, CIR, IIR and histologic findings were noted. Pre-schoolers were further subdivided into those aged < 2 years, and those aged 2 to < 6 years. RESULTS 1671 total colonoscopies were performed, of which 13% (n=219) were in pre-schoolers with median age 3.9 (range 0.3-5.9) years. Most common indications in pre-schoolers were rectal bleeding 35% (n=78), inflammatory bowel disease 24% (n=53), diarrhea 13% (n=30), iron-deficiency anaemia 11% (n=25), and abdominal pain 7% (n=16). IIR and CIR were lower in pre-schoolers compared to older children, 81% vs 92% (p=0.0001), and 93% vs 96.4% (p=0.02), respectively and even lower in those aged < 2 years, 48.1% IIR (p=0.0001) and 85.1% CIR. Juvenile polyps, 31% (n=27), were the most common positive finding in pre-school children. CONCLUSION Rectal bleeding was the most common indication and juvenile polyps the most common finding at colonoscopy in pre-schoolers. A high IIR is achievable in young children but rates are increasingly lower the younger the child.