ESOPHAGOGASTRODUODENOSCOPY PERFORMED BY A FAMILY PHYSICIAN - A CASE SERIES OF 793 PROCEDURES

BACKGROUND. Primary care physicians are performing an increasing numbe r of gastrointestinal endoscopies. The purpose of this research is to present a large case series of diagnostic esophagogastroduodenoscopies (EGDs) performed by a family physician in a solo rural practice. METH ODS. We present a retrospective chart review, including demographic ch aracteristics, indications, endoscopic and pathologic findings, and co mplications for every EGD performed by a family physician over a 7-yea r period. RESULTS. Seven hundred ninety-three EGDs were performed on 6 02 patients (421 women, 181 men), with a mean age of 51.8 years. In 99 % of procedures, the second portion of the duodenum was intubated. The most common indications for EGD were abdominal pain (60.5%), gastroin testinal bleeding (23.0%), dysphagia (11.6%), and heartburn (10.7%). A total of 451 biopsies were obtained in 385 procedures, mostly from th e distal esophagus (38%) or gastric antrum (37%). Common endoscopic di agnoses were gastritis (54%), esophagitis (25%), and normal study (15% ). There were only two malignancies detected, one gastric lymphoma and one carcinoma metastatic to the stomach. One minor complication (0.13 %) occurred, an immediate urticarial rash after intravenous meperidine . CONCLUSIONS. Experienced family physicians can safely and competentl y perform diagnostic EGD and provide this important service to their c ommunity.