الفهرس 
Upper Gastrointestinal Symptoms
Endoscopic FindingsOnly 14 pages are availabe for public view
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Abstract
The upper gastrointestinal tract comprises of the oropharynx (the mouth and associated structures) the oesophagus, or gullet the stomach the duodenum and jejunum (part of the small bowel) These organs are all associated with specific pathologies and disease processes which give rise to a variety of symptom patterns which are vomiting, nausea, regurgitation, dysphagia, dyspepsia, diarrhea and hematemesis and melena (Quigley, 2006).
Indications of upper endoscopy in pediatrics are diverse including children complaining of upper gastrointestinal symptoms like persistent vomiting, gastroesophageal reflux disease, upper GI bleeding, dysphagia, Melena, abnormal or unclear findings on an upper GI X-ray removal of a foreign body or check healing of a previously found ulcer (Kielty, 2008).
Various clinical scores as well as endoscopic and histopathologic grading were introduced, in our study we are discussing the frequency and severity of G.I.T symptoms by using upper gastrointestinal symptoms score for each symptom using well known scoring system as loeb classification (Loeb et al.,1992) also Endoscopic grading and scoring using Modified lanza score (Kobayashi et al., 1990) for grading of gastritis, Hetzel-Dent classification for grading of esophagitis, Joffe (Joffe et al.,2009) for grading of duodenitis, the Histopatholigal grading and scoring using updated Sydney system (Rugge et al., 2003), ESPGHAN (Dent et al., 2005), R. Whitehead classification (Richerad whitehead et al.,1975) .
The present Study is prospective observational study carried out on patients presented to Ain Shams University gastroenterology unit with symptoms related to upper GI to undergo upper endoscopy with biopsy as a part of their diagnostic work up, It was carried out on 133 patients who underwent gastroesophageoduedenoscopy, clinical, endoscopic and histopathology scoring was done done according to previously mentioned scores.
The mean age of the patients presented range from 1 months to 180 months. Males (57.1%) females (42.9%) The present study showed that the most common complains were vomiting (36.8%), hematemesis ( 24.1% ), diarrhea (21.1%), dyspepsia (9%), melena (4.5%) and finally failure to thrive (0.8%).
According to loeb classification most of the patients came with vomiting have frequency more than 10 times (38.8%) and influences on daily activity (42.8%), hematemesis frequency 4 to 6 times (56.2%) and severity can be ignored (56.2),diarrhea frequency 7 to 9 times (57.1) and severity markedly influence on daily activity (50%),dyspepsia frequency more than 10 times (41.6%) and severity influences on daily activity ( 50%) and finally melena frequencies 1 to 3 times (50%) and severity influences in daily activity (33.3%)
The results of the present study showed that 10.5% have nodularity, 30.8 % have incompetent cardia as endoscopic esophageal findings among included patients. 51.9% have grade 0 30.8% have grade 1 4.5% have grade 2 according to Hetzel-Dent classification
The results of the present study showed that 18% have nodularity as endoscopic findings in the stomach. 66.9% showed grade 1,23.3% showed grade 2 5.3% showed grade 3 3% shows grade 4, 1.5% shows grade 5 according to degree of gastritis among included patients according to modified lanza score.
The results of the presented study showed that 28.2% have nodularity, 13.5% have flat mucosa as endoscopic duodenal findings among included patients.88.8% shows grade 1 and 7.7% shows grade 2 according to joffe classification of duodenitis among included patients.
The result of the present study showed that among 37 esophageal biopsies taken from included patients (133) histopathological finding was 54.1% have increased papillary height while 45.9% have normal papillary height. 81.1% has mild degree esophagitis.75.7% have no eisonophils in esophageal biopsy while 24.3% have 5to 10 eisonphils HPF in the biopsy.and finally 81.1% diagnosed as reflux esophagitis as histopatholgical diagnosis while 18.9% have normal mucosa as diagnosis.
The result of the present study showed that among 89 gastric biopsies taken from included patients (133) histopathological finding was 24.7% have H pylori in gastric biopsy.78.7% have mild degree gastritis, 15.7% have normal gastric mucosa and 5.6% have moderate degree gastritis.
39.3% have lymphocytes and plasma cells in their gastric biopsy and 25.8 have all type of cells,93.3%have no eisonophils in gastric mucosa 2.2% from 5 to 10 HPF, 4.5% more than 20% HPF,42.7% were diagnosed as non specific superficial gastritis,22.5% diagnosed as Hpylori gastritis 15% normal mucosa,10.1%atrophic gastritis,4.5%gastric ulcer and finally 4.5 eisonphilic gastritis
The result of the present study showed that among 85 duodenal biopsies taken from included patients (133) histopathological finding was 15.3% have lost villi of the duodenum in the duodenal biopsy 85.9% have mild degree duodenitis,9.4% have moderate degree duodenitis and 4.7% have severe duodenitis. 47.1% have 5 to 10 eisonophils HPF, 42.4% have normal number of eisonophils 3.5% have from 10 to 15 per HPF finally 4.7% have more than 20,72.3% diagnosed as non specific duodenitis and 27.7% have allergic duodenitis.