Esophagogastroduodenoscopy performed by a family physician. A case series of 793 procedures.

BACKGROUND: Primary care physicians are performing an increasing number of gastrointestinal endoscopies. The purpose of this research is to present a large case series of diagnostic esophagogastroduodenoscopies (EGDs) performed by a family physician in a solo rural practice. METHODS: We present a retrospective chart review, including demographic characteristics, indications, endoscopic and pathologic findings, and complications for every EGD performed by a family physician over a 7-year period. RESULTS: Seven hundred ninety-three EGDs were performed on 602 patients (421 women, 181 men), with a mean age of 51.8 years. In 99% of procedures, the second portion of the duodenum was intubated. The most common indications for EGD were abdominal pain (60.5%), gastrointestinal bleeding (23.0%), dysphagia (11.6%), and heart-burn (10.7%). A total of 451 biopsies were obtained in 385 procedures, mostly from the distal esophagus (38%) or gastric antrum (37%). Common endoscopic diagnoses were gastritis (54%), esophagitis (25%), and normal study (15%). There were only two malignancies detected, one gastric lymphoma and one carcinoma metastatic to the stomach. One minor complication (0.13%) occurred, an immediate urticarial rash after intravenous meperidine. CONCLUSIONS: Experienced family physicians can safely and competently perform diagnostic EGD and provide this important service to their community.