Conditions Treated Using Interventional Endoscopy

Physicians at the Interventional Endoscopy Center care for children of all ages with a variety of conditions, from the common to the rare. They may use interventional endoscopy to:

• Diagnose problems in the liver, pancreas and other organs
• Find and remove stones or debris in bile or pancreatic ducts
• Drain fluid for testing or treatment
• Find and remove a tissue sample for testing (biopsy) or remove polyps and masses
• Place a stent or feeding tube
• Treat gastrointestinal (GI) bleeding

Conditions of the Pancreas

Some referrals to the Interventional Endoscopy Center come from doctors at the Cincinnati Children’s Pancreas Care Center. These referrals are often for conditions such as:

Acute, Recurrent and Chronic Pancreatitis - Pancreatitis is inflammation of the pancreas. It can last days, months and, in some cases, years. Mild pancreatitis may go away without treatment. Severe or recurrent cases can last a long time and cause serious complications.

Autoimmune Pancreatitis - This acute or chronic inflammation occurs when the body’s immune system attacks the pancreas.

Exocrine Pancreatic Insufficiency - This digestive condition occurs when the pancreas is damaged and stops producing enough digestive enzymes. It can lead to malabsorption (the inability to absorb nutrients from food).

Congenital Abnormalities

These conditions may develop before a baby is born:

Annular Pancreas - This condition occurs when pancreas tissue surrounds the small intestine in the abdomen. The small intestine can become blocked when this happens, affecting a person’s ability to digest and pass food.

Pancreas Divisum - This condition occurs when parts of the ducts in the pancreas do not join together correctly during development in the womb. This can cause blockage in the pancreatic duct, which can result in pancreatitis.

Choledochal Cyst - This condition occurs when the bile duct does not form properly, creating abnormal cysts within the duct. This can lead to bile duct stones and/or pancreatitis.

Anomalous Pancreaticobiliary Junction - This condition occurs when the bile duct and the pancreatic duct don’t join properly. It can lead to pancreatitis and/or the build-up of sludge, causing a blockage.

Tumors and Cancers of the Abdomen or GI Tract

Interventional endoscopists can detect lesions near the intestine or stomach and remove a small portion for testing. Cancer specialists then use the test results to make a diagnosis and develop a treatment plan.

Liver and Biliary Disease

Our endoscopists work closely with liver disease and liver transplant specialists to care for children with complex conditions. These conditions include autoimmune diseases of the liver or bile ducts, biliary atresia, primary sclerosing cholangitis (PSC), non-alcoholic fatty liver disease and steatosis (NAFLD and NASH), and tumors or masses of the liver. The team offers advanced endoscopic procedures for these patients, including:

• Endoscopic ultrasound-guided biopsies of the liver
• Treatment for strictures, narrowing, leaks and other abnormalities of the bile ducts

Traumatic Injuries

Car crashes, accidents and falls can lead to traumatic injuries to the liver and pancreas.

Stones in the Bile and Pancreatic Duct

Stones that form in the bile duct can block the flow of bile. Stones in the pancreatic duct can block pancreatic duct juices from flowing freely. These blockages can lead to pain, infections or other problems.

Abnormal Fluid Collections or Cysts Within the Abdomen

These fluid collections and cysts sometimes go away on their own. When they don’t, they can cause significant symptoms and require drainage. Types of fluid collections and cysts include:

• Pancreatic cysts—Sac-like pockets of fluid inside the pancreas
• Pancreatic pseudocysts—Non-cancerous pockets of fluid next to the pancreas that are lined with scar tissue and inflammation
• Pancreatic walled-off necrosis (WON)—A pancreatic cyst containing fluid and solid debris

Other GI Conditions

These conditions can include the following:

• Bleeding in areas inaccessible by conventional endoscopy or deep in the small intestine
• Masses, which may be cancerous or non-cancerous
• Narrowing of the esophagus or other parts of the GI tract that could be related to inflammation or a previous surgery
• Polyps, small clumps of cells that forms on the lining of the GI tract.
• Polyposis syndromes including familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome, and juvenile polyposis syndrome (JPS). These rare, hereditary conditions cause numerous polyps throughout the GI tract.