All issues > Volume 38(11); 1995

Original Article

J Korean Pediatr Soc. 1995;38(11):1498-1505. Published online November 15, 1995.

A Clinical Evaluation of the Gastrofiberscopy Studies in Children

Jung Ah JA Park², Young Ho YH Ahn², Jin Bok JB Hwang², Chang Ho CH Han², Hai Lee HL Chung², Young Dae YD Kwon², Jae Bok JB 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

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.

Keywords :Gastrofiberscope, Children, Recurrent abdominal pain, Helicobacter pylori