Oesophagogastroduodenoscopy in a tertiary healthcare facility in south-west Nigeria–a five year review of the spectrum of indications and endoscopic abnormalities
Oguntoye Oluwatosin Oluwagbenga
Background: Complaints of upper gastrointestinal symptoms are common in everyday clinical practice; the underlying aetiology varies widely. Oesophagogastroduodenoscopy (OGD) is the gold standard investigation for evaluating upper gastrointestinal symptoms. It is very useful in the proper diagnosis and determination of the appropriate treatment, including endotherapy, of the underlying pathology. Aim/Objective:To determine the spectrum of indications and endoscopic abnormalities in the patients undergoing Oesophagogastroduodenoscopy at a tertiary healthcare facility located in a rural community in south-west Nigeria. Methods:This was a retrospective cohort study of all patients who had Oesophagogastroduodenoscopy between February 2016 and February 2021 (a period of 5 years). The Age, Gender, Indication and the Endoscopy findings were obtained from the endoscopy register. A total of 208 Oesophagogastroduodenoscopies had been performed over the period. The data obtained was analyzed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Descriptive statistics used included frequency tables, means and standard deviations. Results: A total number of 208 Oesophagogastroduodenoscopies were performed during the period under review, out of which 109 (52.4%) were males and 99 (47.6%) were females with a male to female ratio of 1.1 to 1. The age range of the patients was 9 to 89 years with a mean (±SD) of 52.4(±16.8) years and median of 52.5 years. The highest number of Oesophagogastroduodenoscopies were performed on individuals within the age bracket of 50-59 years whom were mostly females. Dyspepsia was the most common indication for Oesophagogastroduodenoscopy (49.5%) followed by symptoms of upper gastrointestinal bleeding (haematemesis/melaena) 17.9%, unexplained persistent vomiting 6.2%, clinical suspicion of a gastric tumour 6.2% and heartburn 5.3%.The commonest endoscopic abnormality detected from this study was Gastritis 25.5% followed by Gastric erosions 12.5%, Duodenal ulcers 8.7%, Gastric tumours 8.7% and Oesophagitis 6.7%. Normal endoscopy findings were found in 25.0% of the patients. Gastritis was also the commonest endoscopic abnormality (constituting 38.8%) in patients who had Oesophagogastroduodenoscopy done on account of dyspepsia followed by Duodenal ulcers (8.7%) and Gastric erosions (6.8%). Gastric erosions constituted the commonest cause of upper gastrointestinal bleeding in this study (43.2%) followed by Duodenal ulcers (13.5%), Gastric ulcers (10.8%) and Duodenal erosions (10.8%).Conclusion: The commonest indication for Oesophagogastroduodenoscopy in this study was dyspepsia while the commonest endoscopic abnormality was gastritis. Gastric erosion was the most common cause of upper gastrointestinal bleeding. It may therefore be concluded that, Acid-Peptic disorders were the most common underlying gastrointestinal pathologies of patients’ symptomatology necessitating endoscopic evaluation. Certainly, the importance of Oesophagogastroduodenoscopy in the evaluation of patients with upper gastrointestinal symptoms cannot be overemphasized.