Eesophagogastroduodenoscopy in paediatrics: does abiding by the international guidelines lead to appropriate management? A cross-sectional study

Objectives Esophagogastroduodenoscopy (EGD) is one of the most practiced procedures in paediatric gastroenterology. As with all other procedures, it is guided and controlled by specific guidelines developed and approved internationally. The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and the American Society for Gastrointestinal Endoscopy (ASGE) guidelines are two of the most followed guidelines in paediatric gastroenterology. This study aimed to determine how optimal patient condition management is when following international paediatric gastroenterology guidelines and to correlate the appropriateness of EGD and other variables with positive or negative findings on EGD. DESIGN: A cross-sectional retrospective cohort of all first-time diagnostic upper endoscopies was conducted between 1 January 2016 and 1 February 2020, in Prince Hamzah Hospital in Jordan. PARTICIPANTS: Paediatric patients between 9 months and 14 years of age with indications for EGD. RESULTS: Overall, 529 diagnostic EGDs were performed during the study period. Helicobacter pylori-associated gastritis was the most common final diagnosis in 247 patients (47%). Furthermore, 488 (92%) EGDs were deemed appropriate, while 41 (7.7%) were considered inappropriate. Finally, 74.0% of all biopsies performed had positive contributive findings. CONCLUSIONS: Abiding by international guidelines in paediatric gastroenterology can optimise care for paediatric patients. General paediatricians are urged to follow guidelines rigorously when referring patients to minimise inappropriate procedures.