Predictors of positive esophagogastroduodenoscopy outcomes in children and adolescents: a single center experience

Lyons, Hernando; Zhang, Ying; Szpunar, Susan; Dharmaraj, Rajmohan

doi:10.1186/s13104-017-2693-7

Cited by 8 publications

(21 citation statements)

References 26 publications

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“…Sheiko et al reported that more than one-third of children underwent endoscopy at their facility due to abdominal and epigastric pain. [5] In addition, abdominal pain is the most common indication for upper endoscopy in UK, Columbian, and US cohorts [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic yield and appropriate indication of upper endoscopy in Jordanian children

et al. 2021

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Background Upper endoscopy is an essential tool for diagnosing pediatric gastrointestinal issues. This study aimed to assess the indications, diagnostic yields, concordance between histopathological and endoscopic findings and suitability of upper endoscopies performed at a tertiary university hospital in Jordan. Methods Hospital records of children who underwent upper endoscopy were retrospectively reviewed. Demographics, endoscopic details (e.g., indications, findings and any complications), and histopathological findings were collected. The relationship between endoscopic findings and histopathological abnormalities was reported. Results The study included 778 patients (age, 92.5 ± 54.5 months; 380 girls, 48.8%). The most common age group was children younger than 60 months (273 patients, 34.3%). The most common indication for endoscopy was abdominal pain, followed by vomiting and failure to thrive or weight loss. Normal upper endoscopy was reported in 411 patients (52.8%). Age below 60 months, abdominal pain, dysphagia/odynophagia, and heartburn were predictive of abnormal endoscopy in multivariate analysis with p-value 0.000, 0.048, 0.001 and 0.01 respectively. Abnormal endoscopy showed 67.3% sensitivity and 69.9% specificity to predict histopathological abnormalities. Of those performed, 13.6% endoscopies were described as inappropriate indication. The suitability of the procedure was a sensitive predictor for abnormal endoscopic and histopathological findings. Conclusions Abdominal pain is the most common indication for upper endoscopy in our population. It is associated with a higher chance of abnormal endoscopy. Concordance between endoscopic and histopathological findings is not high. Normal endoscopic findings shouldn`t discourage the endoscopist from obtaining tissue biopsies. Considering more biopsies may improve pathological detection rates. Compliance with established endoscopy guidelines may reduce unnecessary procedures.

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Section: Discussionmentioning

confidence: 99%

Diagnostic yield and appropriate indication of upper endoscopy in Jordanian children

et al. 2021

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“…Bu nedenle rutin olarak tüm işlemlerde, mukoza normal görünümde bile olsa duodenum, mide ve özofagustan biyopsiler alınması önerilmektedir (16) . Tüm bu bulgular işığında biyopsi örnekleme çok yaygınlaşmış ve 1985 yılında % 18 olan endoskopi sırasında biyopsi örnekleme oranı, 2005 yılında % 95'e çıkmıştır (7,8) . Bizim üst GİS endoskopisi yaptığımız olguların tümünde özofagus, mide (korpus ve antrum) ile ince barsak (duodenum ve bulbus) mutlaka örneklenmektedir.…”

Section: Bulgularunclassified

“…Çocuklarda GİS endoskopisi ise 1970'li yıllarda uygulanmaya başlamıştır (5,6) . Son 30 yılda pediatrik özofagogastroduodenoskopi (EGD) ve kolonoskopi gibi tanılara yardımcı yeni teknolojilerin kullanımı yaygınlaşmıştır (7) . Sonuç olarak pediatrik EGD ve kolonoskopi, ameliyathanede yapılan nadir işlemlerden, intravenöz sedasyon ve geniş görüntüleme ekranlarını kullanan rutin bir ayakta tedavi prosedürüne evrilmiştir (7,8) .…”

Section: Introductionunclassified

“…Son 30 yılda pediatrik özofagogastroduodenoskopi (EGD) ve kolonoskopi gibi tanılara yardımcı yeni teknolojilerin kullanımı yaygınlaşmıştır (7) . Sonuç olarak pediatrik EGD ve kolonoskopi, ameliyathanede yapılan nadir işlemlerden, intravenöz sedasyon ve geniş görüntüleme ekranlarını kullanan rutin bir ayakta tedavi prosedürüne evrilmiştir (7,8) . Çocuklarda GİS endoskopisi ile üst ve alt GİS mukozası değerlendirilmekte, doku örnekleri ve GİS sıvıları alınabilmektedir.…”

Section: Introductionunclassified

“…Çalışmalar, pediatrik endoskopilerin % 50'sinden fazlasında pozitif bulgular olduğunu bildirmektedir (9,10) . Bu prosedürlerle ilişkili komplikasyon oranları EGD için %1,3 ve kolonoskopi için %1'den azdır (7,11) . Hem endoskopi ve anestezi tekniklerinde gelişmeler, hem de endikasyonlarda artışlar sonucu GİS endoskopileri her yaş çocukta sıklıkla uygulanmaktadır.…”

Section: Introductionunclassified

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Evaluation of pediatric gastrointestinal system endoscopic biopsy findings

Kahraman¹,

Dınız²,

Baran³

2018

Terh

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ÖZAmaç: Gastrointestinal sistem endoskopik araştırmaları günümüzde çoğu büyük tıp merkezinde yaygın olarak kullanılmakta olup; aynı zamanda çocuklarda da güvenle uygulanabilmektedir. Bu çalışma, pediatrik endoskopik biyopsilerin tanısal önemini değerlendirmeyi amaçlamaktadır. Yöntem: Bu çalışma, Aralık 2016'dan Ocak 2018'e kadar sürede yapılan kesitsel tanımlayıcı çalışmadır. Çalışmaya, gastrointestinal sistem endoskopisi uygulanan tüm çocuklar (1 ila 18 yaş arası) alınmıştır. Biyopsi preparatları 2 patolog tarafından yeniden değerlendirilmiştir. Bulgular: Çalışmaya 160 çocuk (56 erkek ve 104 kız) dahil edildi. Endoskopik incelemeye götüren en sık endikasyon karın ağrısı ve kusma idi (%50,7). Prosedürün kendisinden veya verilen sedasyondan sonra hiç komplikasyon tespit edilmedi. Olguların yaklaşık %20'sinde duodenit, %28'inde bulbit, %65'inde gastrit ve %17'sinde özofajit saptandı. Helicobacter pylori enfeksiyonu oranı %35 bulundu. Çölyak hastalığı tanısı konan olgu oranı %7,5 idi. Kolonoskopik incelemede, % 67,8 olguda patolojik bulgu gözlendi. Sonuç: Gastrointestinal endoskopik biyopsi incelemesi, çocuklarda da değerli ve bilgilendirici bir tanı yöntemi haline gelmiştir. Günümüzde işlemin oldukça kolay uygulanabilir hale gelmesi çocukları gereksiz tedavilerden koruma açısından anlamlıdır.Anahtar kelimeler: Çocukluk çağı, gastrointestinal sistem, endoskopi, biopsi ABSTRACT Objective: Gastrointestinal system endoscopic investigations currently are common in most major hospitals and they also can be safely performed in children. This study aims to evaluate the diagnostic importance of pediatric endoscopic biopsies. Method: This is a cross-sectional hospital based study, conducted from December 2016 to January 2018. All children (1 to 18 year-old) who underwent gastrointestinal system endoscopy during the study period were included in this study. Biopsy slides of patients were reevaluated by two pathologists. Results: The present study included 160 children (56 males and 104 females). The most common indication leading to endoscopic examination was abdominal pain and vomiting (50.7%). No complications were detected either from the procedure itself or sedation given. Duodenitis was detected in 20% of cases, bulbit in 28%, gastritis in 65% and esophagitis in 17%. The rate of Helicobacter pylori infection was 35%. The incidence of Celiac diseases was 7.5% in the small bowel biopsies. On colonoscopy, pathological findings were observed in 67.8% of cases. Conclusion: Gastrointestinal endoscopic biopsy examination has also become a valuable and informative diagnostic method in children. Nowadays, making the process very easy to implement is meaningful in terms of protecting children from unnecessary treatments.

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Clinical Utility of Paediatric Endoscopy and Correlation between Endoscopic and Histological Findings

et al. 2022

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Background. The number of gastrointestinal endoscopies in children is rapidly increasing without evidence of a parallel increase in disease burden. The positive yield of paediatric endoscopies outside certain conditions is small but the impact of normal “negative” results on clinical management is poorly studied. Routine mucosal biopsy in all paediatric endoscopies is common practice. We aimed to assess the impact of normal endoscopy on patient care, defined by symptom improvement and discharge from hospital follow-up, and calculate the correlation between endoscopic and histological findings. Methods. Retrospective analysis of the first diagnostic endoscopy in children (2015–2019) from Evelina London Children’ Hospital, in London, UK. Endoscopy and histology findings were recorded. Symptoms and follow-up were reviewed up to six months after the endoscopy. Results. 362 children were included; 46.7% were female. Mean age 10.5 (±4.1) years, 66.3% underwent OGDs, and 33.7% underwent combined OGD and colonoscopies. 72.9% of endoscopies and 57.2% of all biopsies were normal. There was a strong positive correlation between endoscopic findings and biopsy results (phi 0.68 p < .001 ). 31.2% of children reported symptom improvement and were discharged from further follow-up after undergoing endoscopy after 1.9 (±1.5) clinics, phi 0.2 p < 0.001 between normal endoscopy and discharge. Conclusion. Negative endoscopy appears to influence clinical management and discharge from hospital follow-up in about a third of children undergoing endoscopy. The practice of routine biopsies in all paediatric endoscopies should be considered due to a strong positive correlation between normal endoscopies and normal biopsies.

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Predictors of positive esophagogastroduodenoscopy outcomes in children and adolescents: a single center experience

Cited by 8 publications

References 26 publications

Diagnostic yield and appropriate indication of upper endoscopy in Jordanian children

Diagnostic yield and appropriate indication of upper endoscopy in Jordanian children

Evaluation of pediatric gastrointestinal system endoscopic biopsy findings

Clinical Utility of Paediatric Endoscopy and Correlation between Endoscopic and Histological Findings

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