[Indications for esophagogastroduodenoscopy (EGD) in the octogenarian: a first-step investigation?]

Esophagogastroduodenoscopy (EGD) is the most reliable diagnostic method to evaluate the upper digestive tract. It is conceivable that a rising number of very aged patients with dyspeptic symptoms will come to observation as a consequence of the increasing mean age of the population; however there is not yet a complete agreement to submit patients with extremely advanced age to an EGD. The aim of this study is to evaluate the indications and the tolerance of the upper digestive endoscopy in patients more than 80 yrs old. EGD. Two hundred sixteen patients (mean age 84.5 yrs) were submitted to an EGD without any sedation and pharyngeal anesthesia in one-third of cases. Indications were specific symptoms in 52.3% and aspecific in 47.7%. Tolerance was very good with only one case requiring heavy sedation. We do not report complications. As expected, a high percentage of proliferative lesions were found, but also phlogistic and peptic lesions were very common. X-Rays were performed in 20% of cases but false negatives were observed in 11.6% and false positive in 23.2%. Moreover radiological procedures were poorly tolerated in a relatively high percentage of cases. Our experience showed that: 1) EGD is a very well tolerated and safe procedure in patients with very advanced age; 2) unsuspected lesions are found even in patients with aspecific symptoms; 3) EGD should be proposed as a first study in dyspeptic very aged patients being more tolerated and more reliable than X-Rays in these cases.