Exploring indications and findings: A two-year experience in paediatric upper gastrointestinal endoscopy

Abstract

Upper gastrointestinal endoscopy (UGIE) plays a vital role in managing peadiatric gastrointestinal conditions. However, local data on diagnostic and therapeutic yields remain limited. This study aimed to assess the clinical indications, findings, and therapeutic interventions in peadiatric UGIE at the leading tertiary children’s hospital in Sri Lanka. A descriptive study was carried out at the Gastroenterology unit of Lady Ridgeway Hospital for Children, Colombo, from 2023 to 2025. Data were collected retrospectively from the hospital database and analysed using SPSS version 27. A total of 405 UGIE procedures were performed on 292 children (56.8% male and 43.2% female), with a mean age of 7.54 years (SD = 4.38). The majority (96.8%) were elective procedures, with the primary indication for endoscopy being the assessment of prehepatic portal hypertension (39.0%), followed by surveillance endoscopy for peadiatric inflammatory bowel disease (16.4%). Other indications included biliary atresia (9.2%) and Wilson’s disease (5.8%). Esophageal varices were detected in 60% of procedures, while portal hypertensive gastropathy and fundal varices were observed in 10.6% and 7.4%, respectively. Among children with esophageal varices, Grade III varices were the most common (31.4%), with 47.4% affected across three or more columns. The overall diagnostic and therapeutic yields of the procedure were 67.2% and 82%, respectively. Band ligation was the main approach (78.3%), followed by sclerotherapy (2.9%) and glue injection (0.8%). No major procedural complications were reported. Pediatric upper GI endoscopy can be safely and effectively performed across a wide age range and should be introduced early when necessary. It provides a high diagnostic and therapeutic yield in children with portal hypertension and chronic gastrointestinal disorders