Diagnostic yield of esophagogastroduodenoscopy in children with chronic abdominal pain

Akbulut, Ulaş Emre; Emeksiz, Hamdi Cihan; Kocak, Fatma Gulgun; Livaoğlu, Ayten

doi:10.5114/aoms.2017.67675

Cited by 19 publications

(26 citation statements)

References 36 publications

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“…Other investigators have demonstrated high diagnostic yield when EGD was performed for these indications, especially in the presence of alarm symptoms; however, these studies considered mild nonspecific inflammation in the esophagus, stomach, and duodenum to be a positive result. 5,13 These data were consistent with our findings; however, we discovered that, in the absence of H pylori infection, celiac disease, or other rare findings, the presence of mild upper gastrointestinal inflammation did not significantly change clinical management in study participants who were already taking a H2-blocker or a PPI. Our patients who were already on an H2-blocker or PPI were slightly more likely to require a change in clinical management after EGD (9.2% vs 6.0%), but this difference was not statistically significant (P = .3239).…”

Section: Discussionsupporting

confidence: 90%

Utility of Esophagogastroduodenoscopy in the Evaluation of Uncomplicated Abdominal Pain in Children

Reedy

Filipp

Gurka

et al. 2019

Global Pediatric Health

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Esophagogastroduodenoscopy (EGD) is commonly performed for abdominal pain in children, and in the presence of alarm symptoms, the diagnostic yield of this procedure is high. The aim of this study was to investigate the utility of EGD when performed for uncomplicated abdominal pain in children in the absence of alarm symptoms. Charts of all children less than 18 years of age who underwent EGD at the University of Florida between January 2016 and October 2018 were reviewed. Of 1478 children who underwent EGD for any indication, 287 patients (male-to-female = 123:164) were discovered to have undergone EGD, in the absence of colonoscopy, for uncomplicated acute or chronic abdominal pain, nausea, vomiting, gastroesophageal reflux, and/or dyspepsia, with no alarm symptoms. A significant change in clinical management was noted in 20 (7.0%) children. The findings of this procedure changed clinical management in a minority of our study participants.

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Section: Discussionsupporting

confidence: 90%

Utility of Esophagogastroduodenoscopy in the Evaluation of Uncomplicated Abdominal Pain in Children

Reedy

Filipp

Gurka

et al. 2019

Global Pediatric Health

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“…For example, cytokines such as IL-1β, IL-1ra, and IL-6 used for the clinical approach to ulcerative colitis relapse can be investigated in AA and AML [12,23,24]. Colonoscopy may be used for higher diagnostic reliability of AML in children as in a recent study in which esophagogastroduodenoscopy was performed in children with chronic abdominal pain [25]. Thus, in an acute stage of AML, colonoscopy may detect the intestinal changes which could be associated with AML by the same logical approach.…”

Section: Discussionmentioning

confidence: 99%

Acute mesenteric lymphadenitis in children: findings related to differential diagnosis and hospitalization

Özdamar¹,

Karavaş²

2020

aoms

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Introduction: Diagnostic discrimination between acute appendicitis (AA) and mesenteric lymphadenitis (AML) may require more diagnostic tests or great skill after excluding other diagnoses. This study aimed to make a differential diagnosis between AA and AML patients with previous and new parameters and to examine which parameters should be taken into account regarding whether the AML patient should be hospitalized or discharged. Material and methods: One hundred and twenty-three AML and 134 AA patients, randomly selected, were included in the study. Demographic, clinical, and laboratory data of all subjects were analyzed. Ultrasonographic and rarely computed tomography examinations evaluating for the enlarged lymph nodes with the shortest diameter in the right lower quadrant of the AML patients were performed. Also, the erect abdominal radiographs (EAR) of AML and AA patients were evaluated. Results: While there was no statistically significant difference in age or gender, C-reactive protein, white blood cell count, monocyte percentage as well as symptoms between the AA and AML groups (p > 0.05), neutrophil and lymphocyte percentage, appearance of EAR and L/M ratio were significantly different between the two groups (p < 0.05). There was no correlation between the short-axis diameter of the mesenteric lymph node and clinical and laboratory findings in the AML group (p > 0.05). Conclusions: Based on the results with ROC curve analysis, we propose to take into account the L/M ratio and the EAR from the parameters in the differential diagnosis between AA and AML in addition to previously reported parameters. Also, we recommend that the same features may be used to decide whether AML patients under observation are hospitalized or not.

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“…Sheiko et al [9] identified endoscopic abnormalities in 28.9% and histopathological abnormalities in 35.2%. Akbulut et al [10]reported a high diagnostic yield of 56.2% but concluded that a significantly greater diagnostic yield of EGD was present in patients with chronic abdominal pain and alarm symptoms (65.1%) compared to those without symptoms (45.2%). Dahshan et al [11]and Puzanovova et al [12]highlighted the importance of a routine biopsy during the approach of chronic abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Yield of Endoscopic Procedures in Children: Experience of a Portuguese Center

Silva¹,

Silva²,

Espinheira³

et al. 2020

GE Port J Gastroenterol

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Background: Over the last decades, the use of gastrointestinal (GI) endoscopic procedures has been increased in children worldwide, allowing the early diagnosis and therapeutic intervention in multiple GI diseases. Aims and Methods: In order to evaluate the appropriateness and the diagnostic yield of initial GI endoscopic techniques in children in a Portuguese tertiary hospital, we performed a retrospective cohort study during a 12-month period. Results:A total of 308 procedures were performed in 276 patients; the median age was 11 years and 50.4% were males. Esophago-gastro-duodenoscopy (EGD) corresponded to 81.8% of the procedures and ileo-colonoscopy (IC) to the remaining; 11.6% of the patients underwent both EGD and IC. Overall, 51.3% of the exams showed abnormal macroscopic findings, and 69.6% showed histopathological signs of disease, with IC showing significantly more positive results than EGD (p < 0.05). Considering the different indications independently, abnormal serology for celiac disease, suspected ingestion of foreign bodies, suspected inflammatory bowel disease, and food impaction were frequent in our population; and in the majority of the cases, the suspected diagnosis was confirmed: celiac disease, ingestion of foreign bodies, inflammatory bowel disease, and eosinophilic esophagitis, respectively. On the other hand, despite the high frequency of epigastric pain in this population, only nearly one-third of the patients showed abnormal histological findings. The final diagnosis was established in 63% of the patients, and 39.1% initiated the new treatment. Discussion:Our results emphasize the importance of endoscopic procedures, especially IC, in the diagnosis of GI diseases in pediatric patients, as well as the careful choice of the endoscopic techniques in those with less specific symptoms, as chronic abdominal pain. In this particular situation, given the proportion of cases that may be due to functional disease, good characterization of the clinical context is needed, and endoscopy should be reserved for a second-line approach. Conclusion: It is important to monitor and examine the endoscopic techniques as an index of quality criteria for clinical practice.

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Diagnostic yield of esophagogastroduodenoscopy in children with chronic abdominal pain

Cited by 19 publications

References 36 publications

Utility of Esophagogastroduodenoscopy in the Evaluation of Uncomplicated Abdominal Pain in Children

Utility of Esophagogastroduodenoscopy in the Evaluation of Uncomplicated Abdominal Pain in Children

Acute mesenteric lymphadenitis in children: findings related to differential diagnosis and hospitalization

Diagnostic Yield of Endoscopic Procedures in Children: Experience of a Portuguese Center

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