ESOPHAGOGASTRODUODENOSCOPY IN CHILDREN

Abstract

Introduction: Abdominal pain (AP) is a frequent complaint in the pediatric population. It is a common indication for performing an esophagogastroduodenoscopy (EGD) in children. Reflux esophagitis (RE) is a common histological diagnosis that can be associated with AP especially in older children. The objective of this study is to review clinical indications for EGD in our institution and evaluate the reliability of AP in predicting a histological diagnosis of RE. Methods: A retrospective analysis of 437 patients who underwent EGDs between January 2000 and April 2006 was conducted. Data collected included age, gender, clinical indications for EGD. Results: The mean age was 8.15 years (range 0-20 yr). The ratio of M: F was 227:210. The indications for EGD included: recurrent AP (n = 190), failure to thrive (n = 85), suspected food allergies (n = 65), persistent vomiting (n = 83), and others such as upper GI bleeding or IBD surveillance (n = 14). Among 437 patients, 100 patients were found to have histological evidence of reflux esophagitis (RE). AP was the indication for EGD in 44 of RE patients (44%), and 146 of non-RE patients (43.3%) (P = 2.01E-67). The average age of RE patients who presented with AP was 12.1 ± 4 years compared to 5.9 ± 6 years for those presented with other clinical indications (P = 7.48E-08). The average age of non-RE patients who presented with AP was 12.8 ± 3.8 years compared to 4.3 ± 5.3 years for those presented with other clinical indications (P = 4.78E-45). Conclusions: Our study demonstrates that AP alone is not a reliable predictor for the diagnosis of RE. Furthermore, AP is a more common indication for EGD in older children than in younger ones, and does not correlate with diagnostic yield of RE.