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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.

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



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.


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.


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.


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.


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


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