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신생아 및 영아 환아에서 상부위장관 내시경검사의 임상적 유용성
김은주,김홍수,이진우,이문호,김선주,백무준,이혜경,박상흠,권광안,정일권,민용식 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.6
Background/Aims: Endoscopic examination of upper gastrointestinal tract disease in infancy and childhood was introduced 2 decades ago. However, clinical indication, premedication, endoscopic features, and practical problems have been infrequently reported in neonate and infants, Therefore, the usef'ulness and problems of endoscopy in these pediatric patients was evaluated. Methods: Twelve pediatric patients who underwent endos-copic examination which involved a choledochoscope, bronchoscope, and gastrofibroscope included 8 neonates and 4 infants who suffered from gastrointestinal symptoms. Drugs for premedication were chloral hydrate, diazepam, midazolam and ketamine in single or combined administration. Results: Clinical manifestations were hematemesis (67%), melena (42%), vomiting (8%), weight loss (8%), fever (8%) and irritability (8%). Indica-tions for endoscopic examination were upper gastrointestinal Weeding (67%), upper gastrointestinal obstruction (8%), acute drug intoxication (8%), foreign bodies in the stomach (8%) and evaluation for varix (8%). Endo-scopic findings revealed a gastric ulcer (48%), acute gastric mucosal lesion (8/$lt;), external compression on the duodenum (8%), a gastric foreign body (8%), acute esophago-gastritis (8%) and esophageal and gastric varix (8%). Therapeutic endoscopy was performed in 2 patients, One case of hypoxia occurred during diagnostic endoscopy. Conclusions: Endoseopic examination of the upper gastrointestinal tract is a useful and safe proce-dure to detect diseases in neonates and infants if it is done by experienced endocopists and in the circumstances of adequate premedication.