An Inside Look at Pediatric Endoscopies at Arkansas Children’s

The Tools of Endoscopists 

An endoscope is a thin, flexible tube with a tiny camera and light at the end that allows pediatric gastroenterologists, like those at Arkansas Children's, to see some areas inside your child's body without performing external surgery. Some pediatric endoscopes are around twice as wide as a cooked spaghetti noodle, allowing for gentle insertion into the gastrointestinal tract. The camera broadcasts detailed pictures of the throat, stomach or intestines. Pediatric specialists can use the images to identify blockages that prevent swallowing, ulcers and many other conditions. 

A Love for Video Games Translates into Pediatric Endoscopies 

Elaine Odiase, M.D. is the director of advanced and general endoscopy at Arkansas Children’s Hospital (ACH) and an assistant professor of pediatric gastroenterology, hepatology and nutrition at the University of Arkansas for Medical Sciences (UAMS). Odiase is also the only endoscopist in Arkansas certified to perform advanced pediatric endoscopies, which means she can diagnose and treat some conditions using special endoscopes. 

Odiase tells her patients, "When I was your age, I used to love video games." Navigating an endoscope through narrow passages while watching on a screen requires the same precise skills and hand-to-eye coordination as steering a go-kart in Mario Kart. And endoscopies provide more meaningful instant gratification than video games. "[An endoscopy] makes such an impact," she said. Patients often arrive scared and in pain. Some are exhausted from vomiting or not being able to swallow. "They come in one way, and they leave smiling and giving you a hug. And they're able to eat. That is the best thing ever." 

When is a Pediatric Endoscopy Recommended? 

Odiase said the up-close images provided by an endoscopy are helpful when: 

• A child has abdominal pain that hasn’t improved with medication.
• Swallowed food is stuck in the esophagus. 
• A child has prolonged and unexplained vomiting. 
• Blood is present in the child’s stool. 
• Ultrasounds or X-rays haven’t identified the source of a gastrointestinal issue. 

What is an Advanced Pediatric Endoscopy? 

Some endoscopes are more than a camera and a light. Some endoscopes allow gastroenterologists to diagnose and treat some conditions. Advanced or therapeutic endoscopies can: 

• Close internal wounds with brief bursts of heat. 
• Remove small amounts of tissue for testing. 
• Flush a specific area with water. 
• Suction out excess fluids. 

Odiase said one of the most common therapeutic endoscopies she performs at Arkansas Children's is an endoscopic retrograde cholangiopancreatography (ERCP). An ERCP combines X-rays with the images from the endoscope's camera to provide details about a child's liver and pancreas. Disorders in the liver can lead to an excess of bilirubin, a substance found in bile. When the liver doesn't flush out bilirubin, a child may develop jaundice or have unexplained vomiting or itching. An ERCP can be used to remove blockages and restore normal bilirubin levels. 

"Usually, by the time [a patient] sees me, they've gone through a lot of pain; they've gone through a lot of frustration," Odiase said. "Usually, they've seen a lot of specialists or gone to a different hospital and been transferred [to Arkansas Children's], and I can see the relief on a parent's face when I say, 'I know what's going on and this is what we're going to do.'" 

The gastroenterology team at Arkansas Children’s also offers other advanced diagnostic and therapeutic endoscopic procedures, including: 

• Cholangioscopy 
• Electrohydraulic lithotripsy 
• Endoscopic balloon dilation 
• Gastrointestinal sphincter botulin toxin injections 
• Push and single balloon enteroscopy 
• Video capsule endoscopy 

Advanced training combined with state-of-the-art equipment helps our pediatric gastroenterologists make your child better today and healthier tomorrow.