PEDIATRIC UPPER GASTROINTESTINAL ENDOSCOPY IN DEVELOPING-COUNTRIES

A retrospective study of 200 endoscopies performed on 168 children (90 girls and 78 boys) aged 3 months to 18 years (median 6 years) is repo rted. All procedures were completed successfully in an adult endoscopy unit in a comprehensive health centre. Most children of less than 6 m onths and above 12 years of age needed no intravenous sedation. One ch ild developed respiratory depression and was successfully resuscitated . Indications for endoscopy were: small intestinal biopsy, 78 (46%); r ecurrent abdominal pain, 40 (24%); acute epigastric pain, 13 (8%); per sistent vomiting, 12 (7%); haemorrhage, 10 (6%); caustic substance ing estion, six (4%); and dysphagia, four (2%) children. Positive diagnose s were obtained in 123 (62%) procedures. Coeliac disease (26 cases) wa s the most common histological diagnosis, followed by gastritis (19 ca ses), oesophagitis (18 cases), duodenitis (16 cases), duodenal ulcer ( 11 cases), hiatus hernia (six cases), gastric ulcer (three cases) and oesophageal stricture (two cases). Where specialized paediatric endosc opy units are not feasible, e.g. in developing countries, endoscopic s ervices for children can be safely provided by paediatric endoscopists as part of an adult endoscopy service, provided that suitable resusci tation equipment is available and the necessary modifications to meet the medical and psychological needs of children and their parents are taken into consideration.