Spectrum of Upper GI Endoscopy in Children: A Tertiary Centre Experience from Bangladesh

S. Mahmud, Jahida Gulshan, Madhabi Baidya, R. Rashid, Farhana Tasneem, A. Hasan, T. Farhana, D. Begum, Nafis Fatema Asha, Syed Shafi Ahmed
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Abstract

Background: Upper gastrointestinal endoscopy is an essential, safe and sensitive investigation for diagnosing pediatric gastrointestinal diseases. In resource-limited countries like Bangladesh, the practice of pediatric endoscopy remains rudimentary, lacking in trained pediatric endoscopists and appropriate-sized endoscopes. There is limited study on paediatric upper GI endoscopy in our country. Objectives: The aim of the study was to find out the indications, common endoscopic findings and immediate post procedure complication of UGI endoscopy in children. Methods: This is a retrospective study; the records of all the patients whose age is less than 18 years and who underwent endoscopy in the last 6 years were studied. Results: Among the total of 384 children (age <18 years), the most common indications were recurrent abdominal pain in 133 (34.7%) patients followed by hematemesis±melena in 99 (25.8%), esophageal varices (follow up with eradication) in 67 (17.5%), recurrent vomiting in 31 (8.1%), foreign body, CLD screening, suspected celiac disease, isolated splenomegaly, corrosive injury, and weight loss. The most common abnormal findings were gastritis in 103 (26.9%) children followed by esophageal varices in 73 (19.2%), duodenitis in 26 (6.8%), foreign body, esophagitis, hiatus hernia, esophageal stricture, esophageal ulcer, gastric ulcer, duodenal ulcer etc. Minor adverse events occurred in 7.0% of children. Conclusion: The commonest indication for Pediatric UGI endoscopy was recurrent abdominal pain and the commonest endoscopic feature was gastritis. No significant post procedure complication was noted in the study. DS (Child) H J 2021; 37(2): 123-128
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儿童上消化道内窥镜的光谱:来自孟加拉国的三级中心经验
背景:上消化道内镜检查是诊断儿童胃肠道疾病的必要、安全、敏感的检查方法。在孟加拉国等资源有限的国家,儿童内窥镜检查仍然处于初级阶段,缺乏训练有素的儿科内窥镜医生和合适尺寸的内窥镜。我国对小儿上消化道内镜的研究有限。目的:本研究旨在探讨儿童UGI内镜的适应症、常见内镜表现及术后即刻并发症。方法:回顾性研究;研究年龄小于18岁且近6年内行内窥镜检查的所有患者的记录。结果:384例<18岁儿童中,最常见的指征为反复腹痛133例(34.7%),其次为呕血±黑黑99例(25.8%),食管静脉曲张(随访根除)67例(17.5%),反复呕吐31例(8.1%),异物、CLD筛查、怀疑腹腔疾病、孤立性脾大、腐蚀性损伤、体重减轻。最常见的异常表现为胃炎103例(26.9%),其次为食管静脉曲张73例(19.2%),十二指肠炎26例(6.8%),异物、食管炎、食管裂孔疝、食管狭窄、食管溃疡、胃溃疡、十二指肠溃疡等。7.0%的儿童发生轻微不良事件。结论:儿童UGI内镜检查最常见的指征是反复腹痛,最常见的内镜特征是胃炎。研究中未发现明显的术后并发症。DS(儿童)H J 2021;37 (2): 123 - 128
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