Indications, diagnostic yield, and appropriateness of upper gastrointestinal endoscopy in Egyptian children and adolescents: a retrospective two-centre study

Abstract Background Esophagogastroduodenoscopy (EGD) is a crucial diagnostic tool. The ability to do diagnostic and therapeutic endoscopy is a key feature of the current era of gastroenterology. We aimed to evaluate the indications, diagnostic yields, and appropriateness of upper endoscopies carried out at Beni-Suef and Aswan University Hospitals. Methods Demographics and endoscopic information (indications, results, complications and histopathology) were gathered by retrospectively analyzing the files of patients who had upper endoscopies from January 2021 to December 2025, after obtaining research ethical committees approval. Results Our study included 400 patients from 1 to 18 years, with 52% females and a mean age of 7.91 ± 4.24 years. Abdominal pain/dyspepsia (46%) and vomiting (17.5%) were the most common indications for upper endoscopy. Abnormal endoscopic results were noted in 47.25%. The abnormal endoscopy group had substantially greater body mass index (BMI), height, weight, and age ( p < 0.001 for each). Abnormal pathology results were detected in 40.3% of cases. The frequency of normal endoscopy with abnormal histopathology was significantly higher in the Helicobacter pylori gastritis and/or duodenitis group (95% vs. 24.6%, p < 0.001). Age group of 6–12 years and abnormal endoscopy were predictive of abnormal histology. Conclusions Upper endoscopy in children had a sensitivity of 59.6% (95% CI, 51.7–67.2), specificity of 61.1% (95% CI, 54.6–67.3), positive predictive value of 50.8% (95% CI, 43.5–58.1), and negative predictive value of 69.2% (95% CI, 62.5–75.3) in identifying abnormal histopathology, so biopsy of normal-looking mucosa is essential. H. pylori derived most of the normal endoscopy/ abnormal-histology cases (95% vs. 24.6%, p < 0.001). Age group of 6–12 years was predictive of abnormal histology.