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Upper gastrointestinal endoscopy in children
Insights
Upper gastrointestinal endoscopy is a safe and useful diagnostic tool in children for identifying mucosal conditions. This study reviewed 200 pediatric cases, confirming its value in diagnosing various gastrointestinal issues.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
- Diagnostic Procedures
Background:
- Upper gastrointestinal symptoms are common in children.
- Accurate diagnosis is crucial for effective management.
- Fiberoptic endoscopy offers direct visualization of the upper GI tract.
Purpose of the Study:
- To evaluate the utility and safety of upper gastrointestinal fiberoptic endoscopy in pediatric patients.
- To analyze the indications and diagnostic yield of the procedure in children.
Main Methods:
- Retrospective review of 200 consecutive pediatric patients undergoing upper gastrointestinal endoscopy.
- Procedures performed using Olympus P3 or XP-10 gastroscopes.
- Sedation administered with intravenous pethidine and diazepam.
Main Results:
- Common indications included recurrent abdominal pain (46.5%), persistent vomiting (14.5%), and hematemesis (14.5%).
- Endoscopy identified significant pathology such as duodenal ulcers, esophagitis, gastroesophageal reflux, and gastric erosions.
- No major complications were reported in the 200 procedures.
Conclusions:
- Upper gastrointestinal endoscopy is a valuable tool for diagnosing mucosal pathology in children.
- The procedure is safe and well-tolerated in the pediatric population under sedation.
Abstract:
The purpose of this paper is to study the use of upper gastrointestinal (Gl) fiberoptic endoscopy in children. Two hundred consecutive patients referred to one of the authors were reviewed. The indications for performing upper gastrointestinal endoscopy in these 200 patients were: (1) recurrent abdominal pain (46.5%), (2) persistent vomiting (14.5%), (3) haematemesis (14.5%), (4) acute abdominal pain (13%) and (5) other indications such as foreign body removal, failure to thrive and unexplained chest pain (11.5%). The endoscopy was performed with the Olympus P3 or Olympus XP-10 gastroscopes. The sedation used was a combination of intravenous pethidine (2mg/kg) and diazepam (0.5 mg/kg). Among the patients with recurrent abdominal pain, upper Gl endoscopy showed duodenal ulcer in 7 patients (7.5%), duodenitis in 4 (4.3%), oesophagitis in 4 (4.3%) and gastric ulcer in 2 (2.2%). The rest of the patients were normal (81.7%). With regard to persistent vomiting, 37.9% of the patients showed gastroesophageal reflux and 6.9% had a hiatus hernia. Of 29 patients examined endoscopically for upper Gl bleeding, no focus of bleeding was identified in 27.6%. The remaining 72.4% were bleeding from acute gastric erosion (27.6%), oesophagitis (17.2%), oesophageal varices (13.8%), duodenal ulcer (10.3%) and Mallory-Weiss tear (3.5%). The Majority of the patients with acute abdominal pain were normal endoscopically (61.5%). The two common abnormal findings were acute gastritis (27.0%) and acute duodenitis (11.5%). No major complications were encountered during the procedure in these 200 patients. It was concluded that upper Gl endoscopy is useful for defining upper Gl mucosal pathology. The procedure can be performed safely in children under sedation.