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Published in: BMC Pediatrics 1/2022

Open Access 01-12-2022 | Endoscopy | Research

Pediatric esophagogastroduodenoscopy in china: indications, diagnostic yield, and factors associated with findings

Authors: Shengnan Wang, Xiaoxia Qiu, Jingfang Chen, Hong Mei, Haiyan Yan, Jieyu You, Ying Huang

Published in: BMC Pediatrics | Issue 1/2022

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Abstract

Background

Large-scale data on esophagogastroduodenoscopy (EGD) in China are scarce. This study aimed to assess the indications and diagnostic yield of EGD in children and the relationship between factors (such as age, sex, and indications) and diagnostic yield.

Methods

We performed a prospective cross-sectional observational study involving patients aged < 18 years who underwent diagnostic EGD. The study was conducted in five children’s hospitals, each in a different city. Demographic features, indications for endoscopy, and endoscopic and histopathological findings were collected. Univariable and multivariable ordinal logistic regression analyses of the relationship between the factors and diagnostic yield were performed.

Results

The study included 2268 patients (male/female ratio, 1.3:1) with a median age of 8.68 years. Among the 2268 children, the most frequent indications were abdominal pain in 1954 (86.2%), recurrent vomiting in 706 (31.1%), weight loss in 343 (15.1%), and others. The endoscopic yield was 62.5% and was the highest in patients with dysphagia (90.9%). The histologic yield was 30.4% and was the highest in patients with unexplained anemia (45.5%). On multivariable regression analysis, the endoscopic yield was associated with dysphagia, gastrointestinal (GI) bleeding, and recurrent vomiting, and the histologic yield was associated with age. Different groups of patients with abdominal pain had variable probabilities of abnormal endoscopic findings.

Conclusions

The most frequent indication of pediatric EGD is abdominal pain, with variable probabilities of abnormal endoscopic findings in different groups. Endoscopic yield and histologic yield are associated with certain alarming features.

Trial registration

The trial registration number (ClinicalTrials. gov): NCT03603093 (The study was registered on 27/07/2018).
Literature
1.
go back to reference Franciosi JP, Fiorino K, Ruchelli E, Shults J, Spergel J, Liacouras CA, et al. Changing indications for upper endoscopy in children during a 20-year period. J Pediatr Gastroenterol Nutr. 2010;51:4.CrossRef Franciosi JP, Fiorino K, Ruchelli E, Shults J, Spergel J, Liacouras CA, et al. Changing indications for upper endoscopy in children during a 20-year period. J Pediatr Gastroenterol Nutr. 2010;51:4.CrossRef
2.
go back to reference Ament ME, Berquist WE, Vargas J, Perisic V. Fiberoptic upper intestinal endoscopy in infants and children. Pediatr Clin North Am. 1988;35:1.CrossRef Ament ME, Berquist WE, Vargas J, Perisic V. Fiberoptic upper intestinal endoscopy in infants and children. Pediatr Clin North Am. 1988;35:1.CrossRef
3.
go back to reference Squires RJ, Colletti RB. Indications for pediatric gastrointestinal endoscopy: a medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 1996;23:2.CrossRef Squires RJ, Colletti RB. Indications for pediatric gastrointestinal endoscopy: a medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 1996;23:2.CrossRef
4.
go back to reference Eisen GM, Chutkan R, Goldstein JL, Petersen BT, Ryan ME, Sherman S, et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc. 2000;52(6 Pt):1.CrossRef Eisen GM, Chutkan R, Goldstein JL, Petersen BT, Ryan ME, Sherman S, et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc. 2000;52(6 Pt):1.CrossRef
5.
go back to reference Lee KK, Anderson MA, Baron TH, Banerjee S, Cash BD, Dominitz JA, et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc. 2008;67:1.CrossRef Lee KK, Anderson MA, Baron TH, Banerjee S, Cash BD, Dominitz JA, et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc. 2008;67:1.CrossRef
6.
go back to reference Lightdale JR, Acosta R, Shergill AK, Chandrasekhara V, Chathadi K, Early D, et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc. 2014;79:5.CrossRef Lightdale JR, Acosta R, Shergill AK, Chandrasekhara V, Chathadi K, Early D, et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc. 2014;79:5.CrossRef
7.
go back to reference Tringali A, Thomson M, Dumonceau JM, Tavares M, Tabbers MM, Furlano R, et al. Pediatric gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Guideline Executive summary. Endoscopy. 2017;49:1.CrossRef Tringali A, Thomson M, Dumonceau JM, Tavares M, Tabbers MM, Furlano R, et al. Pediatric gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Guideline Executive summary. Endoscopy. 2017;49:1.CrossRef
8.
go back to reference Miele E, Giannetti E, Martinelli M, Tramontano A, Greco L, Staiano A. Impact of the Rome II paediatric criteria on the appropriateness of the upper and lower gastrointestinal endoscopy in children. Aliment Pharmacol Ther. 2010;32:4.CrossRef Miele E, Giannetti E, Martinelli M, Tramontano A, Greco L, Staiano A. Impact of the Rome II paediatric criteria on the appropriateness of the upper and lower gastrointestinal endoscopy in children. Aliment Pharmacol Ther. 2010;32:4.CrossRef
9.
go back to reference Jantchou P, Schirrer J, Bocquet A. Appropriateness of upper gastrointestinal endoscopy in children: a retrospective study. J Pediatr Gastroenterol Nutr. 2007;44:4.CrossRef Jantchou P, Schirrer J, Bocquet A. Appropriateness of upper gastrointestinal endoscopy in children: a retrospective study. J Pediatr Gastroenterol Nutr. 2007;44:4.CrossRef
10.
go back to reference Zullo A, Manta R, De Francesco V, Fiorini G, Hassan C, Vaira D. Diagnostic yield of upper endoscopy according to appropriateness: a systematic review. Dig Liver Dis. 2019;51:3.CrossRef Zullo A, Manta R, De Francesco V, Fiorini G, Hassan C, Vaira D. Diagnostic yield of upper endoscopy according to appropriateness: a systematic review. Dig Liver Dis. 2019;51:3.CrossRef
11.
go back to reference Altamimi E, Odeh Y, Al-Quraan T, Mohamed E, Rawabdeh N. Diagnostic yield and appropriate indication of upper endoscopy in Jordanian children. BMC Pediatr. 2021;21:1.CrossRef Altamimi E, Odeh Y, Al-Quraan T, Mohamed E, Rawabdeh N. Diagnostic yield and appropriate indication of upper endoscopy in Jordanian children. BMC Pediatr. 2021;21:1.CrossRef
12.
go back to reference Wang S, Younus O, Rawat D, Naik S, Giles E, Meadows N, et al. Clinical presentation and outcomes of diagnostic endoscopy in newly presenting children with gastrointestinal symptoms. J Pediatr Gastroenterol Nutr. 2018;66:6.CrossRef Wang S, Younus O, Rawat D, Naik S, Giles E, Meadows N, et al. Clinical presentation and outcomes of diagnostic endoscopy in newly presenting children with gastrointestinal symptoms. J Pediatr Gastroenterol Nutr. 2018;66:6.CrossRef
13.
go back to reference Lyons H, Zhang Y, Szpunar S, Dharmaraj R. Predictors of positive esophagogastroduodenoscopy outcomes in children and adolescents: a single center experience. BMC Res Notes. 2017;10:1.CrossRef Lyons H, Zhang Y, Szpunar S, Dharmaraj R. Predictors of positive esophagogastroduodenoscopy outcomes in children and adolescents: a single center experience. BMC Res Notes. 2017;10:1.CrossRef
14.
go back to reference Sheiko MA, Feinstein JA, Capocelli KE, Kramer RE. Diagnostic yield of EGD in children: a retrospective single-center study of 1000 cases. Gastrointest Endosc. 2013;78:1.CrossRef Sheiko MA, Feinstein JA, Capocelli KE, Kramer RE. Diagnostic yield of EGD in children: a retrospective single-center study of 1000 cases. Gastrointest Endosc. 2013;78:1.CrossRef
15.
go back to reference Lee WS, Zainuddin H, Boey CC, Chai PF. Appropriateness, endoscopic findings and contributive yield of pediatric gastrointestinal endoscopy. World J Gastroenterol. 2013;19:47. Lee WS, Zainuddin H, Boey CC, Chai PF. Appropriateness, endoscopic findings and contributive yield of pediatric gastrointestinal endoscopy. World J Gastroenterol. 2013;19:47.
16.
go back to reference Berger TD, Soffer S, Vurzel-Harel T, Silbermintz A, Fleishaker H, Shamir R, et al. The yield of upper gastrointestinal endoscopy at a Pediatric Tertiary Care Center. Isr Med Assoc J. 2020;22:3. Berger TD, Soffer S, Vurzel-Harel T, Silbermintz A, Fleishaker H, Shamir R, et al. The yield of upper gastrointestinal endoscopy at a Pediatric Tertiary Care Center. Isr Med Assoc J. 2020;22:3.
17.
go back to reference Wani MA, Zargar SA, Yatoo GN, Haq I, Shah A, Sodhi JS, et al. Endoscopic yield, appropriateness, and complications of pediatric upper gastrointestinal endoscopy in an adult suite: a retrospective study of 822 children. Clin Endosc. 2020;53:4.CrossRef Wani MA, Zargar SA, Yatoo GN, Haq I, Shah A, Sodhi JS, et al. Endoscopic yield, appropriateness, and complications of pediatric upper gastrointestinal endoscopy in an adult suite: a retrospective study of 822 children. Clin Endosc. 2020;53:4.CrossRef
18.
go back to reference Thomson M, Sharma S. Diagnostic yield of upper and lower gastrointestinal endoscopies in children in a Tertiary Centre. J Pediatr Gastroenterol Nutr. 2017;64:6. Thomson M, Sharma S. Diagnostic yield of upper and lower gastrointestinal endoscopies in children in a Tertiary Centre. J Pediatr Gastroenterol Nutr. 2017;64:6.
19.
go back to reference Noble AJ, Drouin E, Tamblyn R. Design of predictive models for positive outcomes of upper and lower gastrointestinal endoscopies in children and adolescents. J Pediatr Gastroenterol Nutr. 2008;46:4.CrossRef Noble AJ, Drouin E, Tamblyn R. Design of predictive models for positive outcomes of upper and lower gastrointestinal endoscopies in children and adolescents. J Pediatr Gastroenterol Nutr. 2008;46:4.CrossRef
20.
go back to reference Helin N, Kolho KL, Rintala R, Merras-Salmio L. Upper endoscopy for non-acute non-specific symptoms is seldom beneficial for children under the age of seven. Acta Paediatr. 2020;109:4.CrossRef Helin N, Kolho KL, Rintala R, Merras-Salmio L. Upper endoscopy for non-acute non-specific symptoms is seldom beneficial for children under the age of seven. Acta Paediatr. 2020;109:4.CrossRef
Metadata
Title
Pediatric esophagogastroduodenoscopy in china: indications, diagnostic yield, and factors associated with findings
Authors
Shengnan Wang
Xiaoxia Qiu
Jingfang Chen
Hong Mei
Haiyan Yan
Jieyu You
Ying Huang
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2022
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-022-03558-x

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