Upper endoscopy in children: do symptoms predict positive findings?

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.