A Clinical Evaluation of the Esophagogastroduodenoscopy Studies in Infants and Early Children

ABSTRACT

PURPOSE: Even though the causes and appearance of upper gastrointestinal tract lesions vary with age, attention has seldomly been focused on the infancy and early childhood. This study aimed to provide, as basic material, the experience of esophagogastroduodenoscopy(EGD) in infants and early children. METHODS: The objects were 66 patients(male 40, female 26) who underwent EGD examination in case of endoscopic indication at department of pediatrics of Taegu Hyosung Catholic University Hospital from March 1993 to February 1996. The scope of study included age distribution, chief complaints, endoscopic findings, final diagnosis. RESULTS: 1) The frequency of age distribution was 31.8% under 12 months, 16.6% in 13-24 months, 7.5% in 25-36 months, 7.5% in 37-48 months, 19.6% in 49-60 months and 16.6% in 61-72 months. The 48.4% of total application was done in children under 24 months. 2) The indications were vomiting(29.4%), epigastric pain(20.0%), melena or hematemesis(20.0%), chronic diarrhea(12.9%), recurrent abdominal pain(8.2%), foreign body ingestion(3.5%), drug intoxication(2.3%), chronic cough(1.1%), generalized edema(1.1%) and diagnosis of Peutz-Jeghers syndrome(1.1%). 3) Endoscopic findings were chronic gastritis or duodenitis(21.2%), gastric or duodenal ulcer(13.6%), acute gastritis or duodenitis(7.5%), acute hemorrhagic gastritis or duodenitis(6.0%), reflux esophagitis(4.5%), pyloric stenosis(4.5%), pseudomembranous esophagitis(1.5%), esophageal varix(1.5%), gastric polyp(1.5%), dilatation of distal esophagus (1.5%), whitish discharge through the duodenum(1.5%) and nonspecific findings(34.8%). 4) Final diagnosis were gastroduodenal mucosal lesions with unidentified underlying diseases(37.8%), protracted diarrhea(16.6%), gastroesophageal reflux disease(4.5%), cyclic vomiting syndrome(4.5%), cow's milk allergy(4.5%), idiopathic hypertrophic pyloric stenosis(4.5%), foreign body removal(4.5%), recurrent abdominal pain syndrome(3.0%), drug intoxication(3.0%), Henoch-Schoenlein purpura(1.5%), Peutz-Jeghers syndrome (1.5%), portal vein thrombosis(1.5%), esophageal web(1.5%), intestinal lymphangiectasia (1.5%), small intestinal hemangioma(1.5%), fungal esophagitis(1.5%) and unidentified underlying disease(6.0%). 5) The practices of EGD in infants and early children were done without serious adverse effects. The occurrence of bradycardia was developed in a newborn case during the procedure and was improved shortly after removal of scopy. CONCLUSIONS: The EGD studies were useful means of identifying the upper gastrointestinal anatomy and pathology in infants and early children with upper gastrointestinal symptoms. The practice of pediatric EGD in infants and early children was done without serious side effects. Pediatric EGD is now an integral part of the practice of pediatric gastroenterology.