this protocol aides to evaluate:( 1)whether upper gastrointestinal endoscopy (UGE) is used appropriately according to the Guideline on pediatric GI endoscopy [1] commissioned by the European Society for Paediatric Gastroenterology Hepatology and Nutrition(ESPGHAN) and the European Society of Gastrointestinal Endoscopy(ESGE). In our hospital setting and(2) whether there is any relationship between appropriateness of gastrointestinal endoscopy and the presence of lesions detected by endoscopy.

gastrointestinal endoscopy is a safe and effective procedure. However,complications do exist and procedure-related costs are significant The rapid escalation of the cost of medical care, in the face of limited resources, is making the appropriateness of indications more and more essential to the rational utilization of such resources.Upper Gastrointestinal (UGI) endoscopy in the pediatric population has evolved during the last 30 years with an increasing number of diagnostic and therapeutic applications.

years with an increasing number of diagnostic and therapeutic Technological improvements and endoscopic devices have contributed to the evolution This prospective study is to determine whether upper gastrointestinal endoscopy is used appropriately in our hospital setting according to, the Guideline on pediatric GI endoscopy [1] commissioned by the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and the European Society of Gastrointestinal Endoscopy (ESGE). and whether the appropriateness of use Predicts the probability of detecting significant lesions by endoscopy

Inclusion Criteria:

• Weight loss,

failure to thrive

Unexplained anemia

Abdominal pain with suspicion of an organic disease

Dysphagia or odynophagia

Caustic ingestion

Recurrent vomiting exclusion criteria

patients with perforated viscous

children admitted at assiut university hospital for upper gastrointestinal endoscopy