Diagnostic Yield of Gastrointestinal Endoscopies in Children

Abstract Background Endoscopies proved to be an indispensable tool in pediatric gastrointestinal practice. With the surge in the number of endoscopies and healthcare expenses, it is imperative to ascertain the diagnostic yield of endoscopies to improve patient selection and reduce unnecessary costs. Objective The aim of this study is to evaluate the diagnostic yield of pediatric gastrointestinal endoscopies. Methods Patients undergoing diagnostic endoscopy at one tertiary center in Egypt over the past 5 years, from 2018 to 2023, were included in a retrospective study. Demographic, clinical, endoscopic, and histopathological data were collected and studied. Results 2125 patients aged one month to 16 years, presenting with different symptoms, were evaluated. School age children represented the most common age group (34.6%). The most common indications for upper gastrointestinal(GI) endoscopies were upper gastrointestinal bleed (27.7%) followed by persistent vomiting (24.0%) and failure to thrive and/or chronic diarrhea (17.2%), whereas 77.5% of colonoscopies were performed due to bleeding per rectum. The diagnostic yield (frequency of positive endoscopies) for all GI endoscopies performed is 66.9%. Colonoscopies depicted a higher diagnostic yield of 72.7%, than upper GI endoscopy, of 66.7%. The diagnostic yield of performing both endoscopies together was 62.8%. The most frequent endoscopic diagnoses with upper GI endoscopies alone were gastroduodenitis (27.7%), foreign body ingestion (12.4%), and celiac disease (11.9%). As for colonoscopies alone, GI polyps (48.5%), non-specific colitis (12.1%), and hemorrhoids (7.9%) were most frequent, and for both procedures, suspected inflammatory bowel disease (19.7%), gastroduodenitis (17.4%) and lymphoid nodular hyperplasia were the most common endoscopic diagnoses. GI polyps were found in 40.1% of patients presenting with lower GI bleeds. Failure to thrive and/or chronic diarrhea represented 44.1% of patients undergoing both procedures. Conclusion The diagnostic yield for GI endoscopies is 66.9%, and vary based on age, procedure, and indication. Histologic correlation further increases the diagnostic yield.