Safety and diagnosis yield of colonoscopy in Hong Kong Chinese children

Colonoscopy in children is a highly specialized procedure which is not often performed in the Chinese population. Data of its safety and diagnostic yield in Chinese children is scarce. One of the most common indications for colonoscopy in children of western countries is investigation and follow-up assessment for inflammatory bowel disease which is uncommon in Chinese children. It has recently been reported that there is increasing occurrence of childhood inflammatory bowel disease in western countries. It is, however, unknown whether a similar increase happens in Chinese children.

A research article published on March 7, 2010 in the World Journal of Gastroenterology addresses this issue. The research team led by Dr. Tam YH from the Division of Paediatric Surgery & Paediatric Urology of the Chinese University of Hong Kong has recently reviewed a group of 79 children who underwent their first colonoscopy within a 6 year period in a tertiary referral center. The most common reasons for performing the colonoscopy were investigation for passage of blood in the stools (58%) and for the possibility of inflammatory bowel disease (29%). Colonoscopy identified the pathological conditions in half of the children. These included 23 children with colonic polyps and 13 with inflammatory bowel disease.

Besides the diagnostic purpose, the colonoscopy also provided therapeutic value by successfully excising the colonic polyps in 22 out of 23 children. There were no complications encountered in all 79 children. The authors also found an increasing diagnosis of inflammatory bowel disease in the recent decade compared with the local data in the 80 and 90 s. Their results suggested colonoscopy is a safe procedure in Chinese children although it is not as often done as in western countries. The authors advocated the establishment of a central registry of childhood inflammatory bowel disease to better monitor the trend of the incidence of the disease in Chinese population.