Abstract
BackgroundUpper gastrointestinal (UGI) series is the standard imaging tool for diagnosis of structural and functional abnormalities affecting the esophagus, stomach, and proximal small bowel. The aim of this study was to delineate the clinical indications for UGI series in children that are associated with the presence of significant radiological abnormalities aiming for more standardized care for those patients.ResultsUGI series of 118 patients was analyzed with calculation of clinical score. Vomiting was the most frequent primary complaint (63.6%), followed by dysphagia and recurrent chest infection. Forty-nine patients had positive upper GI findings (42%). The most detected abnormality was related to the stomach and duodenum (21.4%). Variable degrees of idiopathic gastroesophageal reflux were detected in 16 patients (13.6%). Patients with clinical score 2 or more had significantly more prevalence of abnormal findings (p = .001). Vomiting (especially when bilious), underweight, aspiration, and recurrent chest infection were strong predictors of abnormal findings on upper GI series (p = 0.007, 0.001, 0.009, and 0.001, respectively) and increased the diagnostic yield of upper GI series for detection of abnormalities by 3.48, 9.6, 4, and 4.12 times, respectively.ConclusionDiagnostic yield of UGI series was relatively higher in patients having two or more symptoms (clinical score 2 or more) and in children with bilious vomiting, aspiration and underweight, or repeated chest infection.
Highlights
Upper gastrointestinal (UGI) series is the standard imaging tool for diagnosis of structural and functional abnormalities affecting the esophagus, stomach, and proximal small bowel
Vomiting was the most frequently encountered symptom (n = 85; 72.6%), and it was non-bilious in 79 patients; it was the primary complaint in 75 patients
Thirty-five patients reported recurrent chest infection (30%), and it was the primary complaint in only 11 patients
Summary
Upper gastrointestinal (UGI) series is the standard imaging tool for diagnosis of structural and functional abnormalities affecting the esophagus, stomach, and proximal small bowel. The aim of this study was to delineate the clinical indications for UGI series in children that are associated with the presence of significant radiological abnormalities aiming for more standardized care for those patients. Upper gastrointestinal (UGI) series is frequently performed in the pediatric radiology department. It is considered the standard imaging tool for diagnosis of structural and functional abnormalities implicating the esophagus, stomach, and proximal small bowel. It perfectly demonstrates congenital malformations affecting the gastrointestinal tract (e.g., hiatus hernia, intestinal malrotation); in addition, it can depict extra-luminal esophageal compression by an anomalous blood vessel or an external compressing mass. In view of limited resources and emphasis on quality and safety of radiologic procedures, the risk versus potential benefits should be weighed before proceeding with any procedure
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