The Yield of Upper Gastrointestinal Endoscopy at a Pediatric Tertiary Care Center

• Published in: The Israel Medical Association journal 2020-03, Vol.22 (3), p.164-168
• Main Authors: Berger, Tal David, Soffer, Shelly, Vurzel-Harel, Tal, Silbermintz, Ari, Fleishaker, Hava, Shamir, Raanan, Zevit, Noam
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Child, Preschool; Crohn Disease - diagnosis; Crohn Disease - epidemiology; Endoscopy, Digestive System - methods; Endoscopy, Digestive System - statistics & numerical data; Female; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - epidemiology; Gastrointestinal Hemorrhage - diagnosis; Gastrointestinal Hemorrhage - epidemiology; Helicobacter Infections - diagnosis; Helicobacter Infections - epidemiology; Humans; Infant; Israel - epidemiology; Male; Retrospective Studies; Tertiary Care Centers
• ISSN: 1565-1088

The number of investigative esophagogastroduodenoscopies (EGD) in children has increased over several decades, despite their unclear diagnostic yields. To evaluate the indications for performing EGD, their diagnostic yields, and consequences on pediatric patient management. A retrospective chart review was performed of consecutive pediatric patients aged 0-18 years, who underwent EGD between January and August 2014. 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. 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.