Utility of Upper Gastrointestinal Endoscopy in Pediatric Gastrointestinal Disorders in Bangladesh: A Retrospective Study.

Abstract

Over the last few years upper gastrointestinal (GI) endoscopy has been proven to be an effective diagnostic and therapeutic tool for various gastrointestinal diseases in children. This retrospective study was done in a tertiary care center of Bangladesh for one year to assess the indications of upper GI endoscopy including the diagnostic and therapeutic yields for various gastrointestinal disorders in children. During this period, 211 patients, aged ≤16 years, referred either from outpatient clinics or admitted inpatient wards were enrolled in study and their demographic data, endoscopic details (indications, findings and any complications) were collected and normal and abnormal endoscopic findings were compared. Mean age was found 9.5±3.5 years. The most common indication of upper GI endoscopy was recurrent abdominal pain (24.1%) followed by upper gastrointestinal bleeding (20.4%). Normal upper GI endoscopy was found in 74.51% of patients who had recurrent abdominal pain and oesophageal varices were found in 51.16% of patients with upper gastrointestinal bleeding. Upper gastrointestinal bleeding, endoscopic surveillance of oesophageal varices, foreign body ingestion and screening for oesophageal varix in chronic liver disease patient were significantly associated with abnormal upper GI endoscopy findings with p value 0.005, 0.001, 0.019 and 0.001 respectively. This study showed that recurrent abdominal pain was associated with normal upper GI endoscopy result in majority cases, so it should be reserved as second line investigation in patients with recurrent abdominal pain. However, every child with upper gastrointestinal bleeding should be evaluated by upper GI endoscopy. Upper GI endoscopy should be chosen in a justifiable way in paediatric population considering the signs and symptoms of disease.