The yield of upper gastrointestinal endoscopy at a pediatric tertiary care center

Tal David Berger, Shelly Soffer, Tal Vurzel-Harel, Ari Silbermintz, Hava Fleishaker, Raanan Shamir, Noam Zevit

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The number of investigative esophagogastroduodenoscopies (EGD) in children has increased over several decades, despite their unclear diagnostic yields. Objectives: To evaluate the indications for performing EGD, their diagnostic yields, and consequences on pediatric patient management. Methods: A retrospective chart review was performed of consecutive pediatric patients aged 0–18 years, who underwent EGD between January and August 2014. Results: During the study period, 547 EGD were performed on 478 children. The most frequent indications were suspected celiac disease, chronic non-specific abdominal pain, persistent Helicobacter pylori infection, and gastrointestinal hemorrhage. The yield of the diagnostic EGD was 59.2%, and the most common new diagnoses were celiac disease (28%), Helicobacter pylori-positive gastritis (16.5%), and Crohn’s disease (5.4%). Of the patients with documented follow-up, 74.1% reported improved symptoms. Procedures performed for chronic unexplained abdominal pain had significantly lower yields (26.2%) and only 39.3% improved at follow-up. Conclusions: Our findings suggest a general high diagnostic yield for EGD in pediatric patients, stemming mainly from patients in whom a specific condition was suspected a priori. However, the role of the procedure in the diagnosis and management of non-specific gastrointestinal complaints was minor suggesting that EGD may be superfluous for some of these patients.

Original languageEnglish
Pages (from-to)164-168
Number of pages5
JournalIsrael Medical Association Journal
Volume22
Issue number3
StatePublished - Mar 2020

Keywords

  • Abdominal pain
  • Children
  • Endoscopy
  • Gastroscopy

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