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A Clinical Evaluation of the Gastrofiberscopy Studies in Children

Journal of the Korean Pediatric Society 1995;38(11):1498-1505.
Published online November 15, 1995.
A Clinical Evaluation of the Gastrofiberscopy Studies in Children
Jung Ah Park2, Young Ho Ahn2, Jin Bok Hwang2, Chang Ho Han2, Hai Lee Chung2, Young Dae Kwon2, Jae Bok Park1
1Department of Pathology, Taegu Hyosung Catholic University School of Medicine, Taegu, Korea
2Department of Pediatrics, Taegu Hyosung Catholic University School of Medicine, Taegu, Korea
소아 상부위장관 내시경검사의 엄상적 유용성에 관한 고찰
박정아2, 안영호2, 황진복2, 한창호2, 정혜리2, 권영대2, 박재복1
1대구효성가톨릭대학교 의과대학 병리학교실
2대구효성가톨릭대학교 의과대학 소아과학교실
Abstract
Purpose
: This study aimed to provide, as basic material, the experience of gastrofiberscopy in children and the clinical significance of Helicobacter pylori(H. pylori) infection in pediatric gastrointestinal disease.
Methods
: The objects were 99 patients(male 49, female 50) who underwent gastrofiberscopic examination in case of endoscopic indication at department of pediatrics of Taegu Hyosung Catholic University Hospital from March 1993 to June 1994. The scope of study included age distribution, chief complaints, endoscopic findings, H. pylori infection incidences and endoscopic findings in H. pylori infection.
Results
: 1) The frequency of age distribution was 5.3% under 2 years, 9.5% in 3-5 years, 23.4% in 6-8 years, 26.5% in 9-11 years and 35.1% in 12-15 years. The 14.8% of total application was done in children under 5 years. 2) The indications were recurrent abdominal pain(RAP)(38%), acute upper abdominal pain(27.3%), melena or hematemesis(l1.1%), vomiting or nausea(5.1%), anemia or weight loss(5.0%) and foreign body ingestion(2.0%). 3) Endoscopic findings were gastritis(41.3%), duodenitis(17.3%), duodenal ulcer (6.5%), gastric ulcer(3.3%), esophagitis(2.2%), esophageal varix(1.1%), gastric polyp(1.1%), hiatal hernia(1.1%) and nonspecific findings(26.1%). 4) Among 40 cases of H. pylori infection found out by tissue biopsy, rapid urease test and serology antibody test, seven patients of 23 gastritis(30.4%), 1 of 6 duodenitis(16.7%), 1 of 1 gastric ulcer, 2 of 3 duodenal ulcers and 1 of 6 normal cases(16.7%) showed positive response. 5) Age distribution of H. pylori infection was 20% under 5 years, 27.8% in 6-10 years and 35.3% in 11-15 years. This distribution showed that the frequency of positive response increased with age. 6) Among 12 cases of H. pylori identified in the mucosa stained by Giemsa or H & E, Eight cases of serology antibody test(66.7%) and 6 cases of rapid urease test(50.0%) showed positive response. 7) The distribution of endoscopic findings in RAP patients was gastritis (47.4%), duodenitis(l3.2%), duodenal ulcer(10.5%), gastric ulcer(2.6%), esophagitis(2.6%), and nonspecific findings(27.3%).
Conclusion
: The gastrofiberscopic studies were useful means of identifying the upper gastrointestinal anatomy and pathology in children with upper gastrointestinal symptoms. Pediatric gastrointestinal endoscopists are developing unique applications of these techniques for children.
Key Words: Gastrofiberscope, Children, Recurrent abdominal pain, Helicobacter pylori


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