7030 Gastrointestinal endoscopy in a large urban medical center i: esophagogastroduodenoscopy (egd).

Abstract

Few data exist to describe the practice of gastrointestinal endoscopy in a large urban county hospital. These data represent our experience with EGD at Kings County Hospital (KCHC) during the period 1/97 - 5/99. 767 EGDs were perfromed on 397 men (mean age = 52.4 years) and 362 women (mean age = 57.2). 87.7% were done electively in the GI endoscopy suite, and 12.3% were emergency cases done in the ER (7.3%), the MICU (2.3%), SICU (2.3%), or NICU (0.3%). A therapeautic technique was included in 10% of the procedures. Active or recent UGI bleeding was the most common indication (40%) for EGD. Other indications included epigastric pain (22.3%), dysphagia (5.6%), occult GI bleeding with or without iron deficiency anemia (5.1%), and others (27%). 30% of all examinations were performed with no conscious sedation. The rates for successful completion of emergency and routine procedures were 81% and 90% respectively. Endoscopic diagnoses included esophagitis (19.2%), hiatus hernia (19.2%), candida esophagitis (4.6%), esophageal ulcer (4.0%), esophageal varices (3.9%), Mallory Weiss tear (3.3%), Barrett's esophagus (1.3%), esophageal cancer (2.1%), gastritis (31.9%), gastric ulcer (16.8%), gastric cancer (3.3%), gastric polyp (0.9%), duodenitis (15.4%), duodenal ulcer (12.9%), duodenal polyp (0.9%), abnormal papilla (0.7%), active bleed with no source (0.7%) and normal study (8%). There were only two complications (0.3%), both micro-perforations of the cervical esophagus requiring no invasive treatment. Conclusions: A major fraction of EGD in a large urban inner-city county hospital are done for upper GI bleeding. Many procedures are performed without sedation. The incomplete procedure rate is high, but the complication rate is low. The frequency of normal study is low while 10% of all EGD include a therapeautic technique.