A retrospective analyse of esophagogastroduodenoscopy interventions conducted in our endoscopy unit in 2017

Introduction: Esophagogastroduodenoscopy is an interventional procedure performed in identifying oesophageal, gastricus and duodenal diseases. A whole range of symptom considered to be caused by various benign or malignant upper gastrointestinal system diseases can be examined. Objective: We aimed at identifying age and gender distribution of pathological lesions detected by esophagogastroduodenoscopy performed in our endoscopy unit on 500 patients who presented to internal medicine clinic and gastroenterology clinic with gastrointestinal symptoms in our university in 2017. In addition, by detecting endoscopic lesions that are common in our region; we aim to shed light on the works to be planned in the future. Material and method: This study included 500 patients with gastrointestinal symptoms who presented to internal medicine clinic and gastroenterology clinic at the Abant İzzet Baysal University Medical Faculty Hospital in 2017. Esophagogastroduodenoscopy(OGD) results performed in the endoscopy unit of our hospital and biopsy results were retrospectively evaluated. Findings: From the patients included in our study, females are %60 and males are %40, and age average of the females is 54.9±17.7 and age average of the males is 53.9±17.9. Only 18(%3.6) of the 500 patients included in the study was considered as normal. Of the 500 patients, 111(%22.2) had an oesophagus disease, 474 (%94.8) had a gastricus disease and 109 (%21.8) had a duodenal disease. The most frequently observed lesion among the oesophageal lesions is esophagitis and the second is LES laxity. Gastricus lesions are the most frequently observed among all cases. Both among the all gastricus cases and among the all endoscopy cases gastritis is the most frequently observed entity (%93.4). When we look at endoscopic topography distribution of the gastritis cases using the Sydney system, the most frequently observed is pangastritis with %74.6 and the second is antral lesions with %18.2. When we evaluate distribution of gastritis type, the most frequently observed is superficial gastritis with %59, and the second is alkaline reflux gastritis with %19.4. When peptic ulcers are evaluated according to anatomic regions, stomach ulcer occurrence rate is %5.2, and duodenal ulcer occurrence rate is %8.6. Duodenal ulcers were more frequently observed than stomach ulcers. When we histologically examine stomach lesions; inflammation is observed in all biopsy patients (of these, 281 females, 170 males, 451 totally), H.pylori is %36.6, atrophy is %10, intestinal metaplasia is %16, dysplasia is %3.2, and malignancy is %1. Discussion: In our study, among the all cases gastricus lesions are the most frequently observed and both among gastricus diseases and among the all endoscopy cases the most frequently observed disease is gastritis (%93.4). We primarily attribute the substantial rate in comparison to other studies in our country to that there are several health care facilities downtown to which people have easy access. Oesophagitis is the most frequently observed lesion among all oesophageal lesions and the second comes les laxity. Hiatal hernia and esophageal varices incidences are statistically high over 50 years of age. That hiatal hernias generally occur over 50 years of age suggests that constituent parts of hiatus are worn (72). That esophageal varices occur over 50 years of age in our study suggests that varix occurence within cirrhosis is a complication which develops in time after diagnosis. We classified gastritis according to the Sydney system. When we look at endoscopic topographic distribution of gastritis according to the Sydney system, in line with literature pangastritis is the most frequently observed with %74.6, and the second is antral lesions with %18.2. When gastritis type is evaluated, the most frequently observed is superficial gastritis with %59, and the second is alkaline reflux gastritis with %19.4. When peptic ulcers are examined according to anatomical regions, in our study in accordance with literature we found that stomach ulcer occurrence rate is %5.2 and duodenal ulcer occurrence rate is %8.6 and duodenal ulcers are more frequent than stomach ulcers. Malignancy rate among stomach lesions is %1 in our study. When histologically evaluating lesions, according to morphologic distribution, H.pylori is %36.6, atrophy is %10, intestinal metaplasia is %16, dysplasia is %3.2 and malignancy is %1.The lower H.pylori occurrence rate compared to other studies in our country may be attributed to urbanization and socioeconomic status effects. That the HP occurrence rate in our study doesn't differ among age groups shows that the infection develops in early ages and treatment of the infection is insufficient and reinfection is frequent. While atrophy,intestinal metaplasia and dysplasia occurrence rate is bigger over 50 years of age, the rate doesn't statistically differ. Conclusion: Of the 500 patients, 111(%22.2) had an oesophagus disease, 474 (%94.8) had a gastricus disease and 109 (%21.8) had a duodenal disease. Among both gastric diseases and all patients examined by endoscopy the most frequent is gastritis. Helicobacter pylori was seen in 165 (%36.6) of all cases. Considering our study and various studies, upper gastrointestinal endoscopy is generally a safe procedure in patients presenting with gastrointestinal complaints (94, 95, 96, 97). In addition, by detecting endoscopic lesions that are common in our region; we supposed that our study shed light on the works to be planned in the future. Key words: duodenitis, endoscopy, esophagogastroduodenoscopy, gastritis, gastroesophageal reflux, helicobacter pylori, peptic ulcer.