Muhammad Yasin Alvi, Muhammad Ali Khan, Muhammad Yaqub Kazi, Muhammad Ashraf Sultan.
Diagnostic upper gastrointestinal Endoscopy in Pediatric patients: One year review from a Pediatric unit.
Pak Paed J Jan ;29(4):177-81.

Objectives: To review diagnostic upper gastrointestinal endoscopy services in a pediatric department. Methods: Records of all endoscopies undertaken in the department of pediatrics, Services Hospital, Lahore form January 2005 to December 2005 were analyzed. Results: A total of 87 endoscopies were performed during one year period. 49(56.3%) of the patients were males and 38(43.7%) were females. Their ages ranged from 6 months - 15 years. 81(93%) endoscopies were carried out under general anesthesia and 6(7%) with intravenous medazolam sedation. Indications for endoscopy were chronic diarrhoea with suspicion of celiac disease (29.9%), recurrent abdominal pain (28.7%), haematemesis(27.6%), persistent vomiting (5.7%), dysphagia (3.4%) and progressive pallor with failure to thrive (4.6%). Endoscopy revealed normal mucosa in 44(50.6%), gastritis in 17(19.5%), oesophageal varices in 13(14.9%), oesophagitis in 7(8%), esophageal stricture in 4(4.6%) and oesophageal ulceration in 2(2.3%). Histopathological findings were consistent with the diagnosis of celiac disease in 21 (24%) patients. Amongst 13 patients with oesophageal varices, 9 patients were diagnosed as portal vein thrombosis and 4 as liver cirrhosis. 17 patients had gastritis and H. Pylori infection was confirmed on histopathology in 5/17(29%) of this group of children. 23/87(26.4%) of the patients did not have any abnormal findings on endoscopy and histopathological examination. Transient desaturation (02 saturation <90) was the only complication recorded in 5/81 patients, in the general anaesthesia group. Conclusion: Endoscopy is a valuable and safe procedure of utmost importance in the diagnosis of upper gastrointestinal problems in children, providing information on the pattern of upper G.I. diseases in children.

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