Najmul Hassan Shah, Muhammad Sadiq Shah, Ikramullah Khan, Khalid Hameed.
An audit of Diagnostic Upper GI Endoscopy and comparison of booked versus open access cases.
J Coll Physicians Surg Pak Jan ;9(4):174-6.

A retrospective analysis of 2568 consecutive diagnostic upper GI endoscopies at the GI Unit of the Postgraduate Institute, Lady Reading Hospital, Peshawar, was carried out to assess the indications, final outcome and subgroup analysis of the major diagnoses, with comparison of the outcome according to the source of referral. Patients were selected from the gastroenterology OPD and wards (Booked) and referred by other physicians from the outpatient and wards of medical, surgical and allied specialties (Open Access). Results showed significant predominance of male patients (65.72% Vs 35.28%) p=<0.001. Abdominal pain (52.21%), dyspepsia and heartburn (24.96%), haematemesis and/or melaena (15.65%), vomiting (13.94%) and dysphagia (13.27%) making the bulk of the most common indications. There were 943 (36.72%) normal endoscopies more with females dominance (49.12% Vs 29.97%) p = < 0.001. Gastrooesophageal reflux disease was the most common endoscopic finding (23.48%) followed by gastroduodenal Inflammation (16.62%), peptic ulcer disease (15.42%), malignancy (10.00%) and varices (8.09%). Three fifty eight patients (13.94%) showed multiple pathologies. There was no significant difference of outcome on endoscopy between the gastroenterologist and non gastroenterologist selected patients except the varices which were picked up more by non gastroenterlogist for various reasons. The study highlights the significant presence of peptic ulcer disease, upper GI malignancy and oesophageal/gastric varices in our community and sets a baseline for future research and studies with a need for evolving better management strategies for these important health problems.

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