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Clinical and Pathologic Features of Nodular Duodenitis in Children

Journal of the Korean Pediatric Society 2000;43(5):667-673.
Published online May 15, 2000.
Clinical and Pathologic Features of Nodular Duodenitis in Children
Heon Sang Kim1, Jin Hoon Chun1, Yong Joo Kim1, Se Jin Chang2, Eun Kyung Hong2
1Departments of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
2Departments of Pathology, College of Medicine, Hanyang University, Seoul, Korea
소아 결절성 십이지장염의 임상적 소견과 병리학적 소견에 대한 연구
김헌상1, 전진훈1, 김용주1, 장세진2, 홍은경2
1한양대학교 의과대학 소아과학교실
2한양대학교 의과대학 조직병리학교실
Abstract
Purpose
: Nodular duodenitis is defined as two or more erythematous nodules in the duodenum, with surrounding inflammation and with or without apical erosions. But the clinical features and natural history of nodular duodenitis remain largely undefined, therefore we examined clinical, endoscopic and pathologic features of nodular duodenitis in children to find about its natural history, relationship between endoscopic and pathologic findings, relationship between Helicobacter pylori and nodular duodenitis as well as clinical response to antisecretory therapy.
Methods
: Forty-nine children presented with chronic abdominal pain, chronic diarrhea, vomiting and indigestion showed nodular duodenitis on gastroduodenoscopic examinations at the Department of pediatrics of Hangyang University Hospital from January 1995 to August 1997. Endoscopic and pathologic findings were graded and the correlation coefficient between endoscopic and pathologic grades were analyzed. Clinical responses to therapy were compared between Helicobacter pylori(H. pylori)-associated and non H. pylori-associated children.
Results
: The chief most common complaint was chronic abdominal pain and this disease was most commonly developed in females and in school-aged children. In endoscopic examinations, Grade 1 was the most commonly noted, while in pathologic examinations, Grade 2 was most common. The correlation coefficient between endoscopic and pathologic findings was 0.278(P= 0.053). Clinical symptoms were improved by H2-blocker or anti-H. pylori therapy in most patients.
Conclusion
: There was no significant correlation between endoscopic and pathologic grades. H. pylori infection may be an etiologic factor of nodular duodenitis in some cases.
Key Words: Nodular duodenitis, H. pylori infection


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