Endoscopia digestiva alta em crianças e adolescentes: correlação entre as indicações do exame e o diagnóstico etiológico

Abstract

Background: The indications and uses of upper gastrointestinal endoscopy have been expanding in the scope of pediatric gastroenterology, allowing a better approach to several gastrointestinal disorders. In this study, it was evaluated the main indications of this procedure with its diagnostic correlates in children and adolescents who underwent the examination in a specialized endoscopy service. Methods: In this retrospective observational study, conducted between March 2007 and December 2014, data were extracted from the medical records of children and adolescents, between 0 and 13 years from 2007 to 2012, and from 0 to 17 years from 2012 to 2014, who was submitted to upper gastrointestinal endoscopy. Results: A total of 426 records were initially identified as fulfilling the inclusion criteria; of these, 16 were later excluded from the analysis and, therefore, 410 medical records were analyzed in the study. The age ranged from 1 month to 17 years, with a median of 8.8 years, of which 52.4% were female. Epigastralgia and vomiting were the main indications (52.4%) for upper gastrointestinal endoscopy. Of the total number of endoscopic exams, almost half (49%) showed no change. Reflux esophagitis was the most observed diagnosis (43.5%), followed by antralnodosity, esophageal stenosis, enanthematous gastritis and esophageal varices. Conclusions: Although the use of upper gastrointestinal endoscopy in children has increased dramatically in the last decades, there is, strictly speaking, no consensus based on the symptoms, which supports the physician in his/her, indication of this procedure. This became evident with the high percentage of normal exams observed in this study.