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Diagnostic yield of oesophagogastroduodenoscopy in children with abdominal pain.

Thakkar K, Chen L, Tatevian N, Shulman RJ, McDuffie A, Tsou M, Gilger MA, El-Serag HB. Diagnostic yield of oesophagogastroduodenoscopy in children with abdominal pain. Alimentary pharmacology & therapeutics. 2009 Sep 15; 30(6):662-9.

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Abstract:

BACKGROUND: Abdominal pain is the most common indication for oesophagogastroduodenoscopy (OGD) in children. However, existing studies examining the diagnostic outcomes of OGD in children with abdominal pain are limited. AIM: To examine the diagnostic yield of OGD with biopsy in the evaluation of abdominal pain and to describe the endoscopic and histological findings in patients undergoing OGD for abdominal pain of unclear aetiology. METHODS: We performed a retrospective cross-sectional cohort study in children under 18 years of age who had OGD for the primary indication of abdominal pain, at Texas Children''s Hospital and Children''s Hospital of The King''s Daughters from 1 January 2002 to 30 June 2005. RESULTS: Overall, OGD was diagnostic in 454 (38.1%) of the 1191 procedures, including reflux oesophagitis (23%, n = 271), Helicobacter pylori infections (5%, n = 55), peptic ulcers (3%, n = 32), eosinophilic oesophagitis (2%, n = 25), celiac disease (1%, n = 9) and Crohn''s disease (0.5%, n = 7). Male gender, older age, elevated C-reactive protein and vomiting were associated with increased diagnostic yield. CONCLUSIONS: Our findings suggest that OGD is valuable for the evaluation of chronic abdominal pain in children, with a diagnostic yield of 38%. The majority of alarm symptoms and routine laboratory tests are not significantly associated with diagnostic yield.




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