Are Indications and Findings of Upper Gastrointestinal System Endoscopy Changing in Children Over the Years?

Introduction: There are few studies of diagnostic endoscopy indications in children, despite the fact that it is a commonly performed procedure. The aim of the present study was to determine the relation between indications for upper gastrointestinal system (GIS) endoscopy and endoscopic and histopathologic findings in children in an effort to minimize unnecessary procedures. Materials and Methods: The hospital files of 501 children and adolescents 1-18 years of age who underwent diagnostic upper GIS endoscopy examinations between June 2017 and June 2020 were evaluated retrospectively. Results: The mean age of the 501 patients was 14.5±3.1 years and 311 (62.0%) were female. The most common indications for esophagogastroduodenoscopy (EGD) were epigastric pain (38.7%) and abdominal pain (29.3%) with abnormal endoscopic and histopathologic findings of 88.6% and 92.6%, respectively. The co-detection rates of endoscopic and histologic abnormalities for the esophagus, stomach, and duodenum were 71.8%, 97.6%, and 55.8%, respectively. The most commonly detected endoscopic findings were antral gastritis (66.4%), pangastritis (18.0%), bile reflux (12.6%), and duodenitis (9.4%). The most commonly detected histopathologic findings were chronic gastritis (45.3%), chronic Helicobacter pylori gastritis (37.3%), edematous gastric mucosa (5.4%), coeliac disease (4.4%), and esophagitis (4.4%). No complications were associated with the procedure itself or the required sedation. Conclusion: Diagnostic endoscopy indications may vary between countries and centers. It has been established by many studies that the rates of negative endoscopic procedures and complications associated with EGD are high; therefore, the determination of accurate indications for this procedure is important.