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[Upper gastrointestinal endoscopy in pediatrics: experience of a high complexity center in Latin-America]
Tatiana Moreno Estrada1, Maria Rosario Fernández Mejia1, Claudia Liliana Losada G2
1Universidad de Antioquia, Medellín, Colombia.
Insights
Esophagogastroduodenoscopy (EGD) is a safe and effective procedure for pediatric patients. However, one-third of therapeutic EGDs could be prevented with better primary prevention strategies.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Procedures
Context:
- High-complexity hospital setting
- Retrospective study design
- January 2019 - June 2020
Purpose:
- Characterize pediatric patients undergoing esophagogastroduodenoscopy (EGD)
- Evaluate indications, findings, and interventions
- Assess safety and complication rates
Summary:
- 466 pediatric patients (under 14) underwent 552 EGDs.
- Diagnostic EGDs primarily indicated for abdominal pain and GI bleeding.
- Therapeutic EGDs focused on gastrostomy, foreign body removal, and dilation.
- Low complication rates: 0.5% procedure-related, 0.7% anesthesia-related.
Impact:
- EGD is a valuable tool in pediatric care when appropriately indicated.
- Highlights potential for primary prevention to reduce therapeutic EGDs.
- Provides data for optimizing pediatric endoscopic care pathways.
Objective:
To characterize pediatric patients undergoing esophagogastroduodenoscopy (EGD) in a high-complexity hospital.
Patients And Method:
Retrospective study in patients under 14 years of age who underwent EGD at the Hospital San Vicente Fundación de Medellín, between January 2019 and June 2020. The following sociodemographic characteristics were evaluated: age, sex, type of health insurance, place of origin, service where the procedure was indicated, indications for endoscopy, type of care, purpose of the procedure, endoscopic findings, endoscopic intervention, complications associated with the procedure or anesthesia, and relevance of the procedure.
Results:
466 patients who underwent 552 endoscopies were included. Fifty-seven percent of the patients were male. In diagnostic EGD, the main indications were abdominal pain (23%) and upper gastrointestinal bleeding (17%). In therapeutic EGD, the most frequently performed procedures were percutaneous endoscopic gastrostomy (41%), foreign body removal (27%), and esophageal dilation (24%). The complication rate related to the procedure was 0.5% and in relation to anesthesia was 0.7%.
Conclusions:
EGD in pediatric patients is an effective and safe tool if performed with an appropriate indication. One-third of therapeutic EGD could be avoided from primary prevention.
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