Duodenal pathologies in children: a single-center experience

Objective: Several studies have been performed concerning pathologies of the stomach and esophagus in the pediatric age group. However, there have been very few studies of duodenal pathologies in children. The authors aimed to examine the clinical, endoscopic, and histopathological characteristics,...

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Bibliographic Details
Main Authors: Ulas Emre Akbulut, Sami Fidan, Hamdi Cihan Emeksiz, Orhan Polat Ors
Format: Article
Language:English
Published: Elsevier 2018-05-01
Series:Jornal de Pediatria
Online Access:http://www.sciencedirect.com/science/article/pii/S0021755717301031
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Summary:Objective: Several studies have been performed concerning pathologies of the stomach and esophagus in the pediatric age group. However, there have been very few studies of duodenal pathologies in children. The authors aimed to examine the clinical, endoscopic, and histopathological characteristics, as well as the etiology of duodenal pathologies in children. Method: Patients aged between 1 and 17 years undergoing esophagogastroduodenoscopy during two years at this unit, were investigated retrospectively. Demographic, clinical, endoscopic data, and the presence of duodenal pathologies, gastritis, and esophagitis were recorded in all of the children. Results: Out of 747 children who underwent endoscopy, duodenal pathology was observed in 226 (30.3%) patients. Pathology was also present in the esophagus in 31.6% of patients and in the stomach in 58.4%. The level of chronic diarrhea was higher in patients with duodenal pathology when compared with those without duodenal pathology (p = 0.002, OR: 3.91, 95% CI: 1.59–9.57). Helicobacter pylori infection was more common in patients with pathology in the duodenum (59.3%). Conclusion: Duodenal pathology was detected in 30.3% of the present patients. A significantly higher level of chronic diarrhea was observed in subjects with duodenal pathologies compared to those with no such pathology. The rate of Helicobacter pylori infection was considerably higher than that in previous studies. In addition, there is a weak correlation between endoscopic appearance and histology of duodenitis. Resumo: Objetivo: Foram realizados vários estudos com relação a patologias do estômago e esôfago na faixa etária pediátrica. Contudo, poucos estudos das patologias duodenais em crianças. Visamos examinar as características clínicas, endoscópicas e histopatológicas juntamente com a etiologia das patologias duodenais em crianças. Método: Foram investigados retrospectivamente pacientes com idades entre 1 e 17 anos submetidos a esofagogastroduodenoscopia durante dois anos em nossa unidade. Os dados demográficos, clínicos e endoscópicos e a presença de patologias duodenais, gastrite e esofagite foram registrados com relação a todas as crianças. Resultados: Das 747 crianças submetidas a endoscopia, 226 (30,3%) pacientes apresentaram patologia duodenal. A patologia também esteve presente no esôfago de 31,6% dos pacientes e no estômago de 58,4% deles. O nível de diarreia crônica foi maior nos pacientes com patologia duodenal, em comparação aos pacientes sem patologia duodenal (p = 0,002, RC: 3,91, IC de 95%: 1,59-9,57). Infecção por Helicobacter pylori foi mais comum em pacientes com patologia no duodeno (59,3%). Conclusão: Foi detectada patologia duodenal em 30,3% de nossos pacientes. Um nível significativamente maior de diarreia crônica foi observado em indivíduos com patologias duodenais, em comparação aos sem nenhuma patologia. A infecção por Helicobacter pylori esteve presente consideravelmente maior que em estudos anteriores. Além disso, há uma fraca correlação entre a imagem endoscópica e a histologia de duodenite. Keywords: Duodenitis, Endoscopy, Children, Palavras-chave: Duodenite, Endoscopia, Crianças
ISSN:0021-7557