Motamed Farzaneh, Norouzi Sayna, Najafi Mehri, Khodadad Ahmad, Farahmand Fatemeh, Mossahebi Sara, Heidari-Bateni Giv
Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran ; Pediatrics Center of Excellence, Children's Medical Center, Tehran, Iran.
Iran J Pediatr. 2012 Sep;22(3):309-13.
Recurrent abdominal pain (RAP) by itself is one of the common reasons in child-aged patients to refer to a clinician. Some of these patients are presented with more serious features, so-called the "red flag". The most important issue in management of RAP is to distinguish the type of it, whether it is functional or organic. In this study we aimed to assess the redundancy of red-flagged RAP with findings of esophago-gastro-deudonoscopy.
In a 2 year prospective study 150 consecutive children with RAP who showed red flags underwent esophago-gastro-deudonoscopy. The prevalence of each finding was recorded. Overall positive predictive value of predicting an endoscopic finding while having a red-flag was calculated.
Among all the patients, 126 cases showed at least a positive finding in their endoscopy that corresponded to the positive predictive value of 84% for predicting the presence of an endoscopic finding according to red flags. Interestingly, 20% of patients showed hiatus hernia when surveyed.
Comprehensive physical examination is needed to avoid performing esophago-gastro-deudonoscopy without indication in patients with recurrent abdominal pain.
反复腹痛（RAP）本身是儿童患者转诊给临床医生的常见原因之一。这些患者中有一些表现出更严重的特征，即所谓的“红旗征”。RAP管理中最重要的问题是区分其类型，是功能性还是器质性。在本研究中，我们旨在评估有红旗征的RAP与食管胃十二指肠镜检查结果之间的冗余性。
在一项为期2年的前瞻性研究中，对150例有红旗征的连续RAP儿童患者进行了食管胃十二指肠镜检查。记录每项检查结果的发生率。计算有红旗征时预测内镜检查结果的总体阳性预测值。
在所有患者中，126例在内镜检查中至少有一项阳性发现，根据红旗征预测内镜检查结果存在的阳性预测值为84%。有趣的是，在调查时20%的患者显示有食管裂孔疝。
对于反复腹痛的患者，需要进行全面的体格检查，以避免在无指征的情况下进行食管胃十二指肠镜检查。
