|
How to Increase the Diagnostic Yield of Upper-GI Endoscopy in Patients with Non-cardiac Chest Pain
MOHAMMAD FARIVAR and JAMES
KOLTON, DEPT of MEDICINE and DEPT of PATHOLOGY,
NORWOOD HOSPITAL, NORWOOD, MA
42 consecutive patients (16 male, 26 female) underwent upper GI endoscopy
(EGD) for evaluation of non-cardiac chest pain (NCCP). The larynx was observed
for evidence of posterior laryngeal erythema and intra-arytenoid erythema
and edema (mild reflux laryngitis [RL]). Additionally, 4 pinch biopsies were
taken 2-4cm from the gastroesophageal junction to look for evidence of microscopic
chronic esophagitis.
Results: In 42 patients with NCCP, EGD was positive (grades I-IV esophagitis)
in 13 (31%) patients. RL was found in 33 individuals (79%) and biopsies were
positive in 30 patients (64%). Furthermore, in 18 Patients with only NCCP,
endoscopy was positive in 5 (28%), RL was found in 9 (50%) and biopsy was
positive in 7 (39%). In 4 (22%), both RL and biopsies were negative, and
in 6 patients both RL and biopsies were positive.
Conclusions: Addition of laryngoscopy and/or distal esophageal biopsy to
EGD increases the diagnostic yield when evaluating patients with NCCP.
|
