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Acta Paediatr. 2019 Sep 20. doi: 10.1111/apa.15027. [Epub ahead of print]

Upper endoscopy for non-acute non-specific symptoms is seldom beneficial for children under the age of seven.

Author information

1
Department of Paediatrics, Children's Hospital, Paediatric Research Centre, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
2
Department of Paediatrics, Tampere University Hospital, University of Helsinki, Helsinki, Finland.
3
Department of Paediatric Surgery, Paediatric Research Centre, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.

Abstract

AIM:

This study estimated the diagnostic yield of oesophagogastroduodenoscopy (OGD) in young children with non-acute, non-specific gastrointestinal or respiratory symptoms who were treated by a Finnish tertiary level referral centre.

METHODS:

A retrospective chart analysis was performed on 1850 Finnish children under 7 years of age who underwent their first diagnostic OGDs at Helsinki University Hospital during 2006-2016. We noted the endoscopy indications, macroscopic findings, the histology of the mucosal biopsies and the follow-up data.

RESULTS:

After the exclusion criteria were applied, we enrolled 666 patients (57.7% boys) at a median age of 3.5 years. The number of children with non-specific symptoms referred for OGD increased 2.3-fold in 11 years. A routine set of biopsies was obtained in 644/666 (96.7%) of the endoscopies. The OGD was both macroscopically and histologically normal in 519/644 (80.6%) of cases. The most common indication was to rule out gastro-oesophageal reflux disease in 268/666 (40.2%) cases, and the most frequent histological diagnosis was mild to moderate oesophagitis in 57/644 (8.9%) cases. There was no erosive oesophagitis.

CONCLUSION:

The diagnostic yield of macroscopic and histological OGD findings was low in our cohort. Unless there are alarming symptoms, younger children do not need OGD.

KEYWORDS:

biopsy; gastritis; gastro-oesophageal reflux; oesophagitis; respiratory symptoms

PMID:
31538356
DOI:
10.1111/apa.15027

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