Indications, Yield, and Safety Profile of Upper Gastrointestinal Endoscopy in the Paediatric Population at a Tertiary Care Centre

Background: Upper gastrointestinal endoscopy (UGIE) in children is one of the important tools in diagnosis and management of various GI disorders. However, data on the clinical indications, outcomes, and safety of UGIE in children- especially in resource-limited settings remain scarce. Objective: To evaluate the clinical indications, endoscopic findings, demographic patterns, and safety profile of upper gastrointestinal endoscopy (UGIE) in the paediatric population and to assess its role in the diagnosis and management of gastrointestinal disorders in children. Methods: This retrospective observational study included 150 paediatric patients (≤12 years) who underwent UGIE between April 2023 and March 2024 at Department of Medical Gastroenterology, Osmania General Hospital, Hyderabad. Data on demographics, presenting complaints, comorbidities, procedural indications, and endoscopic findings were analysed using descriptive statistics. Results: The cohort had a mean age of 4.6 years, with 91 males (60.7%) and 59 females (39.3%). Common presenting symptoms were hematemesis (24%), abdominal pain (17.3%), corrosive ingestion (17.3%), and dysphagia (13.3%). Upper GI bleeding (24%) was the leading indication, followed by corrosive ingestion (17.3%) and dysphagia (12%). Comorbidities were noted in 71 patients (47.3%), including post-TEF repair (6.7%), acid/alkali ingestion (12.7%), and EHPVO (2.7%). Endoscopy findings were normal in 65 cases (43.3%). Abnormalities included esophageal varices (13.3%), strictures (13.3%), corrosive injuries (11.3%), gastritis/duodenitis (9.3%), and foreign bodies (7.3%). Rare findings (2%) included Mallory-Weiss tear, pyloric stenosis, and Peutz-Jeghers polyp. No major complications were reported; minor events were self-limiting. Conclusion: UGIE is a safe, effective, and clinically valuable procedure in paediatric populations, especially in high-risk scenarios like GI bleeding and corrosive ingestion. The correlation between presenting symptoms and endoscopic indications affirms appropriate procedural triaging. Although a substantial proportion of cases had normal endoscopy, the rate of significant findings supports its continued utilization in well-selected cases.