Same Day Upper and Lower Endoscopy Results in Patients Presenting with Nonspecific Abdominal Pain

Yıl 2015, Cilt: 1 Sayı: 3, 9 - 12, 30.12.2015

Tülay Allahverdi Barlas Sülü

https://doi.org/10.19127/mbsjohs.89218

Cited By: 1

Öz

Objective: The aim of this study was to evaluate the upper gastrointestinal endoscopy and colonoscopy results in patients who presented with abdominal pain and received a diagnosis of nonspecific abdominal pain following the examination and tests.

Methods: We included a total of 52 patients who presented at the emergency service between 01.01.2011 and 01.01.2012 with symptoms of abdominal pain and received a diagnosis of nonspecific abdominal pain following normal examination, routine blood and urine tests and ultrasound analysis. All patients underwent upper gastrointestinal endoscopy and colonoscopy on the same day. The results were evaluated and diagnoses made according to the endoscopy and pathology findings.

Results: There were 23 (44.2%) males and 29 (55.8%) females. The mean age was 54.5 ± 15.3 (23-86) years. A pathology was present on upper endoscopy in 47 (90.4%) patients and lower endoscopy in 27 (51.9%) patients. Comparison of the pathology rates for upper endoscopy and colonoscopy showed a significantly higher rate for upper endoscopy. The most common findings were chronic gastritis with upper endoscopy 13 males (25%) and 17 (32.7%) females, hemorrhoids with colonoscopy 10 males (19.2%) and 12 (23.1%) females. A pathology was present on both examinations in 25 (48%) patients. Cancer was found in 7 (13.5%) patients (6 gastric, 1 colon cancer). Helicobacter pylori was (+) in 53.8% of the cases.

Discussion and Conclusion: Same day upper and lower endoscopy in patients with nonspecific abdominal pain provided important results. However, we feel upper endoscopy should have priority when it is not possible to perform both investigations.

Anahtar Kelimeler

Abdominal pain, Endoscopy, Gastrit

Kaynakça

• Graff LG, Robinson D. Abdominal pain and emergency department evaluation. Emerg Med Clin North Am 2001;19:123-36.
• Lameris W, Randen A, Dijkdraaf M, Bossuyt P, Stoker J, Boermeester M. Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA): Design and rationale. BMC Emergency Medicine 2007;7:9.
• Stefanidis D, Richardson WS, Chang L, Earle B, Fanelli RD. The role of diagnostic laparoscopy for acute abdominal conditions: an evidence-based review. Surg Endosc. 2009;23:16-23.
• Bavunoğlu I, Şirin F. Akut cerrahi karını taklit eden cerrahi dışı nedenler. Türkiye Klinikleri Cerrahi Tıp Bilimleri 2005;10:30-35.
• Özgüç H, Çakın N, Duman U. Akut nonspesifik karın ağrılı olguların bir yıllık prognozları, semptom ve bulguların tanısal doğruluğu. Ulus Travma Acil Cerrahi Derg 2008;14:118-24.
• Aygencel G, Yılmaz U, Karamercan M, Karamercan A, İlhan MN. Acil serviste karın ağrısını değerlendirme maliyeti. Gazi Tıp Dergisi 2009;20:7-12.
• Ağalar F, Özdoğan M, Daphan ÇE, Topaloğlu S, Sayek İ. Akut karınla başvuran geriatrik hastalarda cerrahi tedavi ve sonuçları. Turkish Journal of Geriatrics 1999;2:1-4.
• Luken TW, Emerman E, Effron D. The natural history and clinical findings in undifferentiated abdominal pain. Ann Emerg Med 1993;22:690-6.
• Raheja SK, McDonald PJ, Taylor I. Non-specific abdominal pain-an expensive mystery. J R Soc Med 1990;83:10-1.
• Kraemer M, Franke C, Ohmann C, Yang Q; Acute Abdominal Pain Study Group. Acute appendicitis in late adulthood: incidence, presentation, and outcome. Results of a prospective multicenter acute abdominal pain study and a review of the literature. Langenbecks Arch Surg 2000;385:470-81.
• Van Mook WN, Bourass-Bremers IH, Bos LP, Verhoeven HM, Engels LG. The outcome of esophagogastroduodenoscopy (EGD) in asymptomatic outpatients with iron deficiency anemia after a negative colonoscopy. Eur J Intern Med. 2001 Apr;12(2):122-126.
• Stray N, Weberg R.A. Prospective study of same day bi-directional endoscopy in the evaluation of patients with occult gastrointestinal bleeding. Scand J Gastroenterol. 2006 Jul;41(7):844-50.
• Varadarajulu S, Eloubeidi MA, Patel RS, Mulcahy HE, Barkun A, Jowell P, Libby E, Schutz S, Nickl NJ, Cotton PB. The yield and the predictors of esophageal pathology when upper endoscopy is used for the initial evaluation of dysphagia. Gastrointest Endosc. 2005 Jun;61(7):804-8.
• Harris JK, Froehlich F, Gonvers JJ, Wietlisbach V, Burnand B, Vader JP. The appropriateness of colonoscopy: a multi-center, international, observational study. Int J Qual Health Care. 2007 Jun;19(3):150-7. Epub 2007 Mar 8.
• Thakkar K, Gilger MA, Shulman RJ, El Serag HB. EGD in children with abdominal pain: a systematic review. Am J Gastroenterol. 2007 Mar;102(3):654-61.
• de Dombal FT. The OMGE acute abdominal pain survey. Progress report, 1986. Scand J Gastroenterol Suppl 1988;144:35-42.