scholarly journals Appropriateness of Upper Gastrointestinal Endoscopy: Will the Diagnostic Yield Improve by the use of American Society of Gastroenterology Guidelines?

2016 ◽  
Vol 6 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Muazzam Tahir
2020 ◽  
Vol 40 (2) ◽  
pp. 87-92
Author(s):  
Binita Gurubacharya Joshi ◽  
Madhu Ghimire

Introduction: Gastrointestinal disorders are very common in paediatric population. Upper Gastrointestinal Endoscopy procedures have increased dramatically worldwide and have contributed in identification of various gastrointestinal disorders along with therapeutic benefits. However, it is recently being established in paediatric population in Nepal and proper data is scarce. This study was aimed to assess upper gastrointestinal endoscopy with respect to its indications and diagnostic yield at a tertiary centre over a three years period. Methods: This is a retrospective observational study where data of all paediatric patients between the age group 0 - 15 years having various gastrointestinal problems who underwent upper gastrointestinal endoscopy from March 2013 - Feb 2016 in our centre were analysed. Results: Among 270 patients, males comprised 60% and females comprised 40%. Age range was 0 - 15 years and majority were from the age group between 10 to 15 years (66.2%). Most common indications for endoscopy were chronic abdominal pain (58.8%), acute epigastric pain (18.5%), followed by failure to thrive (7%). Abnormal findings were detected in 250 patients (92.5%); gastroduodenitis (28.14%), antral gastritis (18.51%), erosive gastritis (15.92%), duodenitis (9.25%), hiatus hernia (7.4%), varices (5.5%) were common findings. Histopathologically, chronic gastritis and duodenitis (72%) were common findings followed by acute gastritis and giardiasis. Among 80 patients who underwent RUT, 50% each had positive and negative results. Conclusion: Chronic abdominal pain remains common gastrointestinal problem in children. With the advent of upper gastrointestinal endoscopy various gastrointestinal problems can be identified and managed accordingly. Along with the facility of histopathology, diagnostic yield and outcome is further enhanced.


2011 ◽  
Vol 25 (2) ◽  
pp. 83-88 ◽  
Author(s):  
Dean Keren ◽  
Tova Rainis ◽  
Edy Stermer ◽  
Alexandra Lavy

BACKGROUND: The appropriateness and safety of open-access endoscopy are very important issues as its use continues to increase.OBJECTIVE: To present a review of a nine-year experience with open-access upper gastrointestinal endoscopy with respect to indications, diagnostic efficacy, safety and diseases diagnosed.METHODS: A retrospective, observational case series of all patients who underwent open-access endoscopy between January 2000 and December 2008 was conducted. Indications were classified as appropriate or not appropriate according to American Society of Gastrointestinal Endoscopy (ASGE) guidelines. Endoscopic diagnoses were based on widely accepted criteria. Major complication rates were assessed.RESULTS: A total of 20,620 patients with a mean age of 58 years were assessed, of whom 11,589 (56.2%) were women and 9031 (43.8%) were men. Adherence to ASGE indications led to statistically significant, clinically relevant findings. The most common indications in patients older than age 45 years of age were dyspepsia (28.5%) and anemia (19.7%) in the ASGE-appropriate group, and dyspepsia in patients younger than 45 years of age without therapy trial (6.6%) in the nonappropriate group. Of the examinations, 38.57% were normal. Hiatal hernia and nonerosive gastritis were the most common findings. Important diagnoses such as malignancies and duodenal ulcers would have been missed if endoscopies were performed only according to appropriateness. There were only two major complications and no mortalities.CONCLUSIONS: Open-access upper gastrointestinal endoscopy is a safe and effective system. More relevant findings were found when adhering to the ASGE guidelines. However, using these guidelines as the sole determining factor in whether to perform an endoscopy is not advisable because many clinically relevant diagnoses may be overlooked.


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