Upper gastrointestinal (GI) endoscopy is appropriate in many situations in adults and children.
Recommendations for upper gastrointestinal endoscopy use in children were published by the French-language Pediatric Hepatology, Gastroenterology, and Nutrition Group.
Dr Prevost Jantchou and colleagues retrospectively reviewed the 293 upper gastrointestinal endoscopy procedures undertaken in 251 children.
The endoscopy procedures were undertaken between 2001 and 2003 by 2 senior endoscopists.
The upper gastrointestinal endoscopy procedures were categorized as appropriate or inappropriate based on group's recommendations.
|18% of procedures were considered inappropriate|
|Journal of Pediatric Gastroenterology & Nutrition|
The research team compared diagnostic efficiency in the 2 groups.
Of the upper gastrointestinal endoscopy procedures, 18% were considered inappropriate.
The researchers found that the diagnostic efficiency was 51% in the appropriate group versus 17% in the inappropriate group.
The team noted that the proportion of appropriate upper gastrointestinal endoscopy procedures was higher among inpatients than outpatients.
Inappropriate reasons for performing upper gastrointestinal endoscopy included isolated failure to thrive and follow-up after neonatal esophagogastroduodenitis.
The researchers identified 9 inappropriate upper gastrointestinal endoscopy procedures that contributed useful information.
The team observed that the procedure was conducted in 1 patient with ulcerative esophagitis.
The procedure was undertaken in 4 patients with hemorrhagic esophagitis, and in 1 with duodenitis received the procedure.
The researchers noted malabsorption in 3 patients caused in 1 case by cow's milk allergy, and in 2 cases lead to fully documented celiac disease.
Dr Prevost's team concluded, “Upper gastrointestinal endoscopy was usually performed appropriately in our pediatric hospital.”
“Inappropriate upper gastrointestinal endoscopy procedures were more common in outpatients than in admitted patients.”
“Awareness of the recommendations for appropriate upper gastrointestinal endoscopy use needs to be improved among office-based and hospital-based physicians.”