Abstract
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.
Highlights
Paediatric endoscopies, first described in the 1960s, are often used as a diagnostic tool for children with gastrointestinal complaints [1]
All children had the procedure as day case attendance, and we did not record any complications during endoscopy or after taking biopsies. 72.9% of endoscopies were normal, and 57.2% of all biopsies were reported as histologically normal (p < 0:001)
The relative risk of normal biopsies was 37.37 while the relative risk of abnormal histology after a normal endoscopy was 0.23
Summary
Paediatric endoscopies, first described in the 1960s, are often used as a diagnostic tool for children with gastrointestinal complaints [1]. The number of endoscopies performed in children is increasing but there is no epidemiological evidence of a parallel increase in disease burden [2, 3]. The number of gastrointestinal endoscopies in children is rapidly increasing without evidence of a parallel increase in disease burden. 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. 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. 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
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
