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Upper endoscopy in children: do symptoms predict positive findings?

Baraa Alabd Alrazzak1, Tarek Husien, Deborah L Preston

  • 11Marshall University, Huntington, WV, USA.

Clinical Pediatrics
|April 8, 2014
PubMed

Insights

Upper endoscopy (esophagogastroduodenoscopy or EGD) is often normal in children. Abdominal pain is the most reliable symptom predicting a positive EGD, suggesting improved referral guidelines are needed.

Area of Science:

  • Pediatric Gastroenterology
  • Diagnostic Endoscopy

Background:

  • Upper endoscopy (esophagogastroduodenoscopy or EGD) is a key diagnostic method for pediatric gastrointestinal issues.
  • The incidence of EGD procedures in children has significantly increased.
  • A high rate of normal EGD findings (approximately 50%) in pediatric patients necessitates optimizing procedural indications.

Purpose of the Study:

  • To evaluate the diagnostic yield of initial EGDs in children based on referral symptoms.
  • To identify clinical symptoms that best predict positive findings during EGD in pediatric patients.
  • To inform primary care physician referral practices and reduce unnecessary EGD procedures.

Main Methods:

  • Retrospective study design.
  • Analysis of pathological findings from the first EGD in children referred for various gastrointestinal symptoms.
  • Assessment of the predictive accuracy of different referral symptoms for positive EGD results.

Main Results:

  • Abdominal pain emerged as the most frequent referral symptom.
  • Abdominal pain demonstrated the highest accuracy (79.9%) in predicting positive EGD findings.
  • Other investigated symptoms showed less than 50% accuracy in predicting positive EGD outcomes.

Conclusions:

  • Most common gastrointestinal symptoms in children have limited predictive value for positive EGD findings.
  • Abdominal pain is the strongest predictor of positive EGD in the pediatric population.
  • A cost-benefit analysis for EGD in children is recommended to refine referral strategies and resource allocation.

Keywords:
EGDchildrenreferral symptomsupper endoscopy

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