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Excerpt
Background: A retrospective review comparing the visualized endoscopic appearance and histopathologic findings on biopsies during upper gastrointestinal endoscopy was undertaken in children. 204 patients were evaluated by an upper gastrointestinal endoscopy, all of whom had esophageal biopsies and 59 had gastric biopsies as well. Methods: Endoscopic findings included erythema, granularity, abnormal vascular patter, friability, erosions, plaques, ulceration and strictures and histologic evaluation of biopsies was undertaken by one pathologist according to the presence of and type of cellular infiltrate and cellular morphologic abnormalities in the mucosa and submucosa where available. Results: In this study the correlation was poor in both the esophagus and the gastric mucosa. The discrepancy was illustrated by poor sensitivity and specificity for endoscopy in both location being 67% and 61% for the esophagus and 86% and 43% for the gastric mucosa respectively. No single endoscopic finding had a reliable correlation with histologic diagnosis but some had higher predictive value than others. Of the multiple indications for endoscopy in children, recurrent abdominal pain had the least diagnostic yield. Conclusions: Endoscopic findings correlate poorly with the histologic diagnosis in the gastro-esophageal mucosa in children. We recommended routine biopsying from all anatomic locations during endoscopy regardless of the appearance of the mucosa.
