Recurrent abdominal pain and upper gastrointestinal endoscopy findings in children and adolescents presenting at the Lagos University Teaching Hospital

IntroductionRecurrent abdominal pain (RAP) is a common reason for referral to the paediatric gastroenterology unit and the attending physician needs to be able to rule out an organic cause when evaluating any child with this condition. The aim of this study was to describe the endoscopic findings in children who presented to the paediatric gastroenterology unit of the Lagos University Teaching Hospital (LUTH) with RAP.MethodsThis was a prospective descriptive study which was conducted from January 2015 to July 2018 at the Paediatric Gastroenterology unit of the department of Paediatrics and the endoscopy unit of the LUTH, Lagos, Nigeria. All children and adolescents ≤ 19 years old with recurrent abdominal pain who were referred for upper GI endoscopy during the study period, were recruited. Baseline sociodemographic data, dyspepsia and alarm symptoms if present were documented. Results of other investigations namely stool examination for ova, parasites, occult blood and faecal antigen for Helicobacter pylori and abdominal scan were also documented.ResultsA total of 113 children with recurrent abdominal pain was referred during the study period and 87 (76.7%) of them had upper GI endoscopy done. Out of the participants, 38(43.7%) were boys and 49(56.3) girls. Alarm features were present in 15(17.6%) and dyspepsia was seen in 22(25.3%) of the subjects. The main endoscopic findings were: gastritis in 39 (44.8%), gastric erosions in 14(16.2%), hiatus hernia in 7(8.1%), duodenitis in 6 (6.9%), gastric polyp in 4 (4.6%).ConclusionUpper GI endoscopy remains an invaluable tool in the tool in evaluating RAP in children as it enables accurate diagnosis of GI causes of RAP. There is a need to advocate for easier access to this procedure in the developing countries.

引言 复发性腹痛（Recurrent Abdominal Pain, RAP）是儿科消化科转诊的常见病因，接诊医师在评估此类患儿时，需明确排除器质性致病原因。本研究旨在描述尼日利亚拉各斯大学教学医院（Lagos University Teaching Hospital, LUTH）儿科消化科收治的复发性腹痛患儿的内镜检查结果。方法 本研究为前瞻性描述性研究，于2015年1月至2018年7月在尼日利亚拉各斯的拉各斯大学教学医院（LUTH）儿科消化科及内镜中心开展。研究纳入研究期间因复发性腹痛转诊行上消化道内镜检查的所有≤19岁儿童及青少年。收集受试者的基线社会人口学资料、消化不良症状及预警症状（若存在），同时记录其他检查结果，包括粪便虫卵、寄生虫、隐血检测，幽门螺杆菌（Helicobacter pylori）粪便抗原检测及腹部扫描结果。结果 研究期间共计113名复发性腹痛患儿转诊就诊，其中87例（76.7%）接受了上消化道内镜检查。纳入受试者中，男性38例（43.7%），女性49例（56.3%）。15例（17.6%）存在预警症状，22例（25.3%）存在消化不良症状。主要内镜检查结果如下：胃炎39例（44.8%）、胃糜烂14例（16.2%）、食管裂孔疝7例（8.1%）、十二指肠炎6例（6.9%）、胃息肉4例（4.6%）。结论 上消化道内镜检查仍是评估儿童复发性腹痛的宝贵手段，可精准明确复发性腹痛的消化道致病原因。在发展中国家，应推广并提高该检查的可及性。