Gastrointestinal Tract In Children Research Articles

Эндоскопическая характеристика верхних отделов желудочно-кишечного тракта у детей с аллергопатологией

Общепризнанной является взаимосвязь между поражениями желудочно-кишечного тракта (ЖКТ) и аллергическими заболеваниями. Известно и действие медиаторов аллергии, которые способствуют развитию воспаления ЖКТ. Цель исследования: изучить состояние верхних отделов ЖКТ для улучшения качества оказания медицинской помощи детям с аллергопатологией.Материалы и методы. Проанализировано 61 эндоскопическое исследование детей в возрасте от 6 мес. до 17 лет с аллергопатологией. Результаты обработаны методами вариационной статистики.Результаты и их обсуждение. В структуре аллергических заболеваний 43 % — дети с сочетанной аллергопатологией, 31 % — с аллергическим ринитом, 18 % — с бронхиальной астмой (БА), 8 % — с ангиоотеком. Деструктивные изменения ЖКТ выявлены у 23 % больных. Деструкция всех отделов ЖКТ чаще наблюдалась у больных БА, двенадцатиперстной кишки (ДПК) — у 31 % детей с сочетанной патологией. Эритематозные изменения желудка выявлены у 91 % больных БА и 85 % больных с сочетанной аллергопатологией. Эритематозные поражения ДПК отмечались у 82 % больных БА и у 58 % — с сочетанной аллергопатологией. Эритематозные поражения пищевода выявлены у 27 % больных БА и 20 % детей с ангиоотеком. У 32,8 % обследованных отмечалась лимфоидная гиперплазия различных отделов ЖКТ. Дуоденогастральный рефлюкс диагностирован у 44,2 % пациентов. Выводы. 1. У детей с аллергопатологией поражения органов пищеварения составляют: 15 % — пищевода, 67 % — желудка, 60 % — ДПК. 2. Деструктивные формы, представленные эрозиями, составляют 23 %. 3. Наиболее неблагоприятной патологией для развития поражения ЖКТ является БА и ее сочетания. 4. У 32,8 % больных отмечается лимфоидная гиперплазия ЖКТ. 5. Дуоденогастральный рефлюкс выявлен у 44,2 % обследованных.

Аналіз функціонального стану шлунково- кишкового тракту у дітей із бронхолегеневою дисплазією

Проаналізовано особливості функціонального стану шлунково-кишкового тракту в дітей із бронхолегеневою дисплазією. Показано, що діти із бронхолегеневою дисплазією мають значно нижчі показники фізичного розвитку, ніж практично здорові діти. Встановлена залежність між гіпопротеїнемією сироватки крові та патологічними змінами в копрограмі дітей із бронхолегеневою дисплазією, що повинно враховуватися під час клінічного менеджменту даного контингенту дітей.

Endoscopic changes in the gastrointestinal tract in children with helicobacteriosis

Background: All over the world, chronic gastroduodenal pathology (CGDP) occurs in children from 3.2% to 52% and takes 2nd place after diseases of the respiratory system. The main pathogen is Helicobacter pylori (HP), and the problem of studying endoscopic changes in the stomach and duodenum in n these children remains relevant. This study investigated changes observed by esophagogastroduodenoscopy (EGD) examination of the mucous layer of the upper digestive tract in children CGDP and its features in HP infection. Methods: A total of 128 children aged 6 to 15 years exhibited CGDP. All patients underwent EGD, with a description of the visible mucous membrane of the stomach and duodenum. Research on HP infection was carried out by two methods: a breath test and an immunochromatographic faecal test. Results: It was noted that the rate of Helicobacter pylori infection was higher in patients with ulcerative lesions of the gastrointestinal tract than in patients with inflammatory processes (on average 1: 0.6). A high prevalence of gastroesophageal and duodenogastric reflux was revealed in patients with HP infection. In children with HP infection, atrophic lesions of the antrum and body of the stomach, bulbar and distal duodenum prevailed. Conclusions: Gastric ulcers and duodenal ulcers developed 94% more often in children with HP infection than in HP-uninfected patients (P<0.005), and atrophic changes in the mucous layer of the stomach and intestines were 4 times more common against the background of the more common gastroduodenal (by 77.6%) and duodenogastric (by 67.4%) reflux.

Analysis of gastrointestinal tract pathology structure in children

Summary. Diseases of the digestive system occupy one of the leading places in the structure of somatic pathology in childhood. The prevalence of chronic diseases of the gastroduodenal zone, intestines, liver and biliary tract in children is growing both in Ukraine and in the countries of Western Europe and North America. The structure of the pathology of the digestive system is made up of anomalies and malformations, functional and organic diseases and neoplasms. In young children functional disorders predominate, while in adolescents the number of inflammatory, organic diseases of the stomach, duodenum and large intestine increases significantly. The dependence of the incidence rate on the time of year remains. The number of cases of combined pathology and comorbid diseases also tends to increase. Modern diagnostic methods make it possible to identify and differentiate diseases at an early stage. This improves the prognosis significantly. Aim of the research to analyze the structure and characteristics of diseases of the gastrointestinal tract in children. Materials and methods: The results of the activity of Kharkiv Municipal Children’s Hospital №19" for 2017-2019 were analyzed according to the specialized department of pediatric gastroenterology. Results. During the period of observation of the gastrointestinal disease, 8511 patients were diagnosed: in 2017 - 3042; 2018 - 2836; 2019 - 2633. The structure of pathology was dominated by diseases of the stomach and duodenum: 2017 - 2068/3042 (67.98 ± 0.84%), 2018 - 2007/2836 (70.76 ± 0.81; 2019. - 1781/2633 (67.64 ± 0.91%). Diseases of the liver and biliary tract, as well as diseases of the pancreas and intestines, were the second and the third in terms of prevalence, respectively. Conclusions. 1. pathology of the digestive system occupies a leading place in the structure of children morbidity in Ukraine as a whole, and in the Kharkiv city; 2. there is a tendency to decrease the hospitalization of children with gastrointestinal diseases 3. among gastrointestinal diseases the first place is occupied by pathology of the stomach and duodenum; 4. children under 12 years old are dominated by functional disorders; 5. there is a need for early diagnostics and treatment of children in medical institutions.

ОСТРЫЕ ВИРУСНЫЕ ИНФЕКЦИИ С СОЧЕТАННЫМ ПОРАЖЕНИЕМ РЕСПИРАТОРНОГО И ЖЕЛУДОЧНО-КИШЕЧНОГО ТРАКТА - БИЧ СОВРЕМЕННОСТИ?

Viral infections continue to cause significant morbidity and mortality worldwide. The association of pathogens often changes not only the typical clinical picture of the infection, but also its course, which often becomes the reason for the delayed diagnosis and lack of adequate treatment. The variety and discovery of new respiratory viruses, their variability, the rapid formation of strains resistant to antiviral agents and modifying adaptive immune responses in humans, lead to an increase in the frequency of mixed viral infections, which dictates the need to develop and implement new diagnostic and treatment algorithms. This review is devoted to the problem of acute viral infections with combined lesions of the respiratory tract and gastrointestinal tract (GIT) among the population of children. The etiological structure of causative agents of acute respiratory infections (ARI), acute intestinal infections (AII) and infections with combined lesions of the respiratory tract and GIT in children is presented. The features of the pathogenesis and clinical features of rotavirus, coronavirus infections are considered. An algorithm for making a decision on the appointment of a treatment-and-prophylactic complex for children with AII and ARI is proposed.

Cross-Functional Syndrome of Gastrointestinal Diseases in Adults and Children in the Context of Their Continuity

This review provides an analysis of a possible relationship between functional diseases of the gastrointestinal tract in children and adults. Some functional disorders previously identified only in the childrens age group, such as abdominal migraine, were increasingly recorded in the adult population. As a rule, the diagnosis of functional gastrointestinal diseases is based primarily on clinical symptoms. However, researchers increasingly note that for some pathologies in children, such as gastroesophageal reflux disease, the main symptoms of reflux, such as heartburn and belching, are not absolutely dominant. All this makes it possible to express an opinion on the formation of a universal functional pathology of the digestive tract with the dominance at certain stages of the pathological process of one or another symptomatology that affects the central nervous system.

Infant colic: where is the line between norm and pathology, the role of disruption of the intestinal microbiome

Infant colic is one of the most common functional disorders of the gastrointestinal tract in children of the first year of life, worsening the condition of both the child himself and the psychological climate in the family. Infant intestinal colic is a multifactorial symptom complex that requires differential diagnosis between norm and pathology. Until now, there is no clear understanding of the criteria for the need for dietary and drug correction of this condition. The article presents an analysis of the modern literature on the problem of intestinal colic in infants The pathogenesis of functional intestinal colic is determined by a combination of reasons, including the immaturity of the central nervous system, hypothalamic-pituitary system, regulation of the intestinal innervation and the enzymatic system, a certain dependence on psychosocial factors has also been identified, the intestinal microflora has a great influence. H. Kianifar et al. (2014) in the findings of a study noted that a multiprobiotic (seven strains of probiotics and fructooligosaccharides) significantly improved colic symptoms, in particular a reduction in crying time, (82.6%) compared with placebo (35.7%) on day 7 of intake (p &lt; 0.005). On day 30, treatment success was 87% and 46% in the synbiotics and placebo groups, respectively (p &lt; 0.01). The results of a domestic study by I.N. Zakharova et al. (2016) multiprobiotic, which showed that after the use of a multistrain probiotic, intestinal colic remained in 3 (10%) children of the main group and in all children in the placebo group. After taking the probiotic, 80% of children showed normalization of stool, and in the placebo group, stool disorders (loose, watery stools or no stool with the need to empty after an enema) were recorded in 87% of children. Cases from clinical practice with experience of using a multistrain probiotic for colic are shown.

Особенности цитопротекции слизистой оболочки желудка и двенадцатиперстной кишки у подростков с хроническим гастродуоденитом на фоне пищевой гиперчувствительности

Актуальность. В наше время остаются недостаточно изученными цитопротективные свойства желудочно-кишечного тракта у детей с хроническим гастродуоденитом на фоне пищевой гиперчувствительности. Целью нашего исследования стало оценить состояние цитопротективного потенциала слизистых оболочек (СО) желудка и двенадцатиперстной кишки у подростков с хроническим гастродуоденитом на фоне пищевой гиперчувствительности путем определения уровня трефоилового фактора 1 (TFF-1) в слизистой оболочке желудка и TFF-2 слизистой оболочки желудка и двенадцатиперстной кишки иммуногистохимическим методом. Материалы и методы. Исследование проведено 50 подросткам (от 12 до 17 лет), из которых в I группе было 64 % (n = 32) с хроническим гастродуоденитом на фоне пищевой гиперчувствительности, во II группе — 36 % (n = 18) детей с хроническим гастродуоденитом без пищевой гиперчувствительности. Всем детям выполнено морфологическое и иммуногистохимическое исследование биоптатов с определением TFF-1 и TFF-2. Оценка экспрессии ­TFF-1 и TFF-2 пептидов проводилась по балльной шкале по количеству окрашенных клеток эпителия желез антрального отдела и бокаловидных клеток в поле зрения при увеличении в 40 раз: 0 баллов — отсутствует окрас, 1 балл — 30 % окрашенных клеток, 2 балла — 30–70 % окрашенных клеток, 3 балла — 70–100 % окрашенных клеток. Результаты. Выраженная экспрессия TFF-1 (3 балла) в слизистой желудка имела место у подростков обеих групп. По результатам проведенного исследования, у 62,5 % (n = 20) детей первой группы и у 22 % (n = 4) подростков II группы в СО двенадцатиперстной кишки отсутствовала окраска бокаловидных клеток (0 баллов) (c2 = 7,5; p = 0,008). Слабая экспрессия (1 балл) имела место у 34,5 % (n = 11) детей I группы и у 67 % (n = 12) детей II группы (c2 = 4,84; p = 0,03). По результатам статистического анализа группа детей с пищевой гиперчувствительностью имеет в 17 раз выше шансы на возникновение атрофических изменений слизистой двенадцатиперстной кишки. Выводы. У детей с пищевой гиперчувствительностью снижены цитопротективные свойства слизистой оболочки двенадцатиперстной кишки, о чем свидетельствует отсутствие экспрессии TFF-2 пептида. Также достоверно чаще возникают микроэрозии, уменьшение количества крипт и бруннеровых желез в СО двенадцатиперстной кишки в группе детей с пищевой гиперчувствительностью при отсутствии или слабой экспрессии TFF-2 пептида (р &lt; 0,05).

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A Quantitative Assessment of Mucosal Eosinophils in the Gastrointestinal Tract of Children Without Detectable Organic Disease.

Accurate measurements of mucosal eosinophil concentrations in gastrointestinal tracts of healthy children are necessary to differentiate health and disease states in general, and better define eosinophilic gastrointestinal diseases. We retrospectively reviewed gastrointestinal biopsies from children with macroscopically normal endoscopies, who, after a minimal follow-up of one year, were not diagnosed with any organic disease. Peak eosinophil concentrations and distributions were assessed from each segment of the gastrointestinal tract. Three centers (Italy, United Kingdom, and Israel) contributed 202 patients (median age 13 years IQR 9.5-15.5, range 1-18 years). Median (IQR, range) eosinophil concentrations (eos/mm2) were: esophagus 0 (0-0, 0-84), stomach 0 (0-4, 0-84), duodenal bulb 20 (13-30, 7-67), second part of duodenum 20 (13-29, 0-105), terminal ileum 29 (14-51, 0-247), cecum 53 (37-89, 10-232), ascending colon 55 (25-84, 0-236), transverse colon 38 (21-67, 4-181), descending colon 29 (17-59, 0-114), sigmoid colon 25 (13-40, 0-215) and rectum 13 (4-28, 0-152). Significant geographical variance was present, however, no differences in eosinophil concentrations were identified between children with resolving symptoms vs. those with functional diagnoses, nor across age groups. Standardized eosinophil concentrations from the gastrointestinal tracts of children without organic disease will serve to better define both health and disease states. No differences were found between resolved symptoms vs. functional diagnoses nor between age groups in this pediatric cohort.

Rare case of mucinous colon adenocarcinoma in a teenager: case study

A rare clinical case of a malignant epithelial tumor in an adolescent, 16 old — mucinous adenocarcinoma of the colon with invasion of the intestinal wall, growth into the mesentery, retroperitoneal space and regional lymph node is presented. The article presents data on epidemiology, features of the clinical course, predisposing factors in malignant epithelial tumors of the gastrointestinal tract in children and adolescents.

“Old” and “new” probiotics in the treatment of gastroenterological diseases in children and adults: how to increase effectiveness?

The purpose of the review is to analyze the real benefits of the use of traditional probiotics and to highlight the issues of the possibility of creating and using new generation probiotics in the treatment of gastroenterological pathology. Questions of effectiveness of therapy with traditional probiotics of functional and organic diseases of the gastrointestinal tract in children and adults from the points of view of evidence-based medicine are analyzed, insufficient number of studies in children and frequent absence of significant differences in the effect of probiotics compared to placebo are emphasized. New generation probiotic candidates are described, which could become potential sources of new drugs for various diseases, including gastroenterological pathology. The main problems in the way of creation and introduction of new probiotics are outlined. Data on an alternative approach of probiotic therapy based on use to restore microbiocenosis of own bacteria, which are grown as pure genetically characterized cultures and can be used as probiotic products, are presented.

Digestional diseases in Covid‑19 in children

The new coronavirus infection (COVID‑19) caused by the SARS-CoV‑2 coronavirus is rightfully recognized as a pandemic of the 21st century and poses a threat to the health of all human race. According to the World Health Organization, at October 4, 2020, were registered worldwide 34,804,348 confirmed cases of COVID‑19, including 1,030,738 deaths. According to currently available data, children accounted for 1 to 5% of patients diagnosed with COVID‑19 [4]. Children aged between 10–18 years dominated (45.9%), and patients first years of life accounted 26.1%. At the same time, over the period since the beginning of the pandemic, only a few fatal outcomes of the disease in children have been recorded in world statistics.The high contagiousness of the SARS-CoV‑2 coronavirus, the ability for long-term replication, and tropism for the cells of the immune system provide the virus with the possibility of almost simultaneous multiple organ damage with the rapid development of complications of both the respiratory tract and other organs and systems.The gastrointestinal tract is involved in this pathological process, representing one of the “shock organs”. In addition to common respiratory symptoms, some COVID‑19 patients experience dyspeptic disorders such as diarrhea, nausea, and vomiting. Anal swab samples from patients positive for COVID‑19, are positive for SARS-CoV‑2 nucleic acid, and SARS-CoV‑2 were isolated from stool samples from COVID‑19 patients. In addition, in both adults and children, there is a strong association between damage to the digestive system and SARS-CoV‑2 infection. This review summarizes the manifestations and potential mechanisms of gastrointestinal manifestations in COVID‑19 in children.The aim of the work is a review of current data on the lesion of the gastrointestinal tract in children with COVID‑19 infection, and its impact on the management of patients with chronic diseases of the digestive tract.Materials and methods of research. Was carried out the analysis of publications in PubMed, EMBASE and Web of Science systems in the period from December 2019 to June 2020, documenting the clinical course of COVID‑19 disease with gastrointestinal lesions. The following search terms are used: “COVID‑19”, “SARS-CoV‑2”, “coronavirus”, “SARS-CoV‑2 pandemic, epidemic”, “outbreak”, “diarrhea”, “gastrointestinal symptoms”, “stool”, “feces” without any language restrictions. The main source of information was full-text scientific publications of both, foreign and russian authors.In addition, clinical cases of COVID‑19 were analyzed among patients of infectious departments of the Children’s Clinical Hospital named after Z. A. Bashlyaeva, Moscow. Clinical manifestations of the disease, data from laboratory and instrumental studies were evaluated. The most informative of them is given as a clinical example.

Current issues of GERD surgical treatment in children.

Introduction:Gastroesophageal reflux disease is one of the most common diseases among a wide range of chronic inflammatory diseases of the gastrointestinal tract in children of all ages, significantly impairing the quality of life of the child and posing a serious threat to the health of the patient.Materials and Methods:From 2008 to 2019, 134 patients aging from 6 months to 12 years were hospitalized at the Scientific Center for Pediatrics and Pediatric Surgery, including 69 (51%) infants. Of them, 51 (38%) were the patients with persistent manifestations of regurgitation, despite an outpatient course of conservative therapy; 29 (22%) patients with recurrent reflux-associated pneumonia; also, 35 (26%) children with gastroesophageal reflux in the structure of the main pathology of the central nervous system, as well as 19 (14%) patients after surgery of the anastomosis of the esophagus with its atresia. One hundred and seven (79.8%) patients underwent surgery. Nissen esophagofundoplication was traditionally performed in 41 (38%) patients, in combination with Stamm gastrostomy in 14 (34%), with Mikulich pyloroplasty in 9 (22%), and in combination with gastrostomy and pyloroplasty in 12 (29%) children. Laparoscopic Nissen esophagofundoplication was used in 16 (15%). Thall esophagofundoplication was performed in 48 (45%) patients, whereas in two (2%) cases, Borema gastropexy was conducted.Results:The immediate results were studied in all 107 patients. Complications in the form of gastric distress syndrome were revealed in four (3.7%) patients who did not undergo pyloroplasty, which in two (1.9%) cases required additional surgery of the stomach draining, whereas in the other two (1.9%) patients, the distress syndrome was stopped conservatively. A dumping syndrome was identified in two (1.9%) patients.Conclusion:Timely recognition of the pathological process, its nature, and prevalence determines the indications for the use of various methods of operation, which are based on an individual approach to each patient.

Current issues of gastro-oesophageal reflux disease surgical treatment in children.

Gastro-oesophageal reflux (GER) disease is one of the most common diseases amongst a wide range of chronic inflammatory diseases of the gastrointestinal tract in children of all ages, significantly impairing the quality of life of the child and posing a serious threat to the health of the patient. From 2008 to 2019, 134 patients aging from 6 months to 12 years were hospitalised at the Scientific Center for Pediatrics and Pediatric Surgery including 69 (51%) infants. Of them, 51 (38%) were the patients with persistent manifestations of regurgitation, despite an outpatient course of conservative therapy; 29 (22%) patients with recurrent reflux-associated pneumonia; also, 35 (26%) children with GER in the structure of the main pathology of the central nervous system, as well as 19 (14%) patients after surgery of the anastomosis of the oesophagus with its atresia. One hundred and seven (79.8%) patients underwent surgery. Nissen oesophagofundoplication was traditionally performed in 41 (38%) patients, in combination with Stamm gastrostomy in 14 (34%), with Mikulich pyloroplasty in 9 (22%) and in combination with gastrostomy and pyloroplasty in 12 (29%) children. Laparoscopic Nissen oesophagofundoplication was used in 16 (15%) cases. Thall oesophagofundoplication was performed in 48 (45%) patients, while in two (2%) cases, Boerema gastropexy was conducted. The immediate results were studied in all 107 patients. Complications in the form of gastric distress syndrome were revealed in four (3.7%) patients who did not undergo pyloroplasty, which in two (1.9%) cases required additional surgery of the stomach draining, whereas in the other two (1.9%) patients, the distress syndrome was stopped conservatively. A dumping syndrome was identified in two (1.9%) patients. Timely recognition of the pathological process, its nature and prevalence determines the indications for the use of various methods of operation, which are based on an individual approach to each patient.

Clinical report and analysis of 24 cases of multiple magnetic beads foreign body in gastrointestinal tract of children.

This study aimed to analyze the data of 24 cases of multiple perforation or obstruction of the digestive tract caused by accidental ingestion of magnetic beads, to improve the understanding of its harmfulness to children and explore the best treatment. In total, 24 cases were collected and retrospectively analyzed. These patients were divided into two groups: perforation group and non-perforation group. The medical history, number of magnetic beads, white blood cell (WBC) count, and C-reactive protein (CRP) were analyzed. There was no significant difference in age, gender, medical history, number of magnetic beads, and WBC count between the perforation group and non-perforation group, but there was a significant difference in CRP. After the diagnosis, 70% of the cases underwent laparotomy and perforation repair. All cases recovered smoothly after the operation, and no complications occurred during the follow-up. This study offers diagnosis and treatment methods for the perforation or obstruction of the digestive tract caused by accidental ingestion of magnetic beads and raises the awareness regarding the harmfulness of the presence of foreign bodies in the digestive tract.

Recurrent Abdominal Pain: A Rare Presentation of Childhood Intestinal Lymphoma in a Bangladeshi Child

In children, primary malignant tumors of the gastrointestinal (GI) tract are rare and accounts less than 5% of all pediatric neoplasms.1 Non-Hodgkin’s lymphoma (NHL) remains the most common malignancy of the GI tract in children.2 Moreover small intestine (PLI) is very uncommon. They are different in anatomic distribution and histologic appearance compared to common patterns in adult cases. The disease is rare and having variable clinical presentation that delayed early detection when the possibility of cure exists. The common presentations of PLI are bowel obstruction and intussusception.3,4 NHL of the gastrointestinal tract usually arises in the submucosal lymphoid tissue of the ileocecal region, extendtransmuraly, and involve local mesenteric lymph nodes extensively, forming a bulky abdominal mass. NHL most frequently involved the ileocecal valve (35.8%), followed by the small bowel (31.3%), large bowel (19.4%) and multiple gastrointestinal involvements (13.4%).5 Here we present a case report to show the scenario of a patient suffering from NHL where diagnosis was delayed. The child was suffering from recurrent abdominal pain (RAP) and various treatment was offered but he could not improve. Finally, he was diagnosed as a case of primary non-Hodgkin's lymphoma of the small intestine (PLI). Though PLI is a very uncommon malignancy in childhood.&#x0D; Northern International Medical College Journal Vol. 11 No. 1 July 2019, Page 438-439

The influence of Helicobacter pylori on the level of endotheline-1 and nitrogen oxide in the blood of children with the duodenal ulcer

The most serious pathology of the of gastrointestinal tract in children remains duodenal ulcer (DU). Interesting is the study of the role of endothelin-1 and nitrogen oxide in the formation of DU.The aim. To evaluate the nature of changes in the level of nitrogen oxide (NO) and endothelin-1 (Et-1) in the blood of children with H pylori-associated DU.Methods. A single-center study was conducted in 42 children with DU aged 6–18 years and 20 children comparison group. Diagnostics of H. pylori was performed primary endoscopy and 4 weeks after the end of treatment. Blood samples were collected in each visit to measure plasma Et-1 using an enzyme immunoassay kit and NO (nitrate/nitrite) levels Golikov's method.Results. In 37 (92.5%) the ulcers went through re-epithelialization, while successful eradication of H. pylori was achieved in 32 people (80%). The NO level in the blood plasma of the children of the main group was 9.78 ± 1.13 mmol/l, after treatment –11.09 ± 1.2 mmol/l. After eradication of H. pylori, the level of Et-1 decreased from 2.39 ± 0.08 to 1.14 ± 0.07 pg / ml.Conclusion. Levels of endothelin-1 (Et-1) and nitrogen oxide (NO) in children with duodenal ulcer vary depending on the stage of the disease. After H-pylori eradication, ulcer defect healing is associated with decreased of Et-1 inplasma and increased NO activity.

The characteristics of video capsule endoscopy in pediatric Henoch\u2013Sch\xf6nlein purpura with gastrointestinal symptoms

BackgroundHenoch–Schönlein purpura (HSP) is a systemic small-vessel vasculitis also named IgA vasculitis that commonly affects the gastrointestinal tract. The video capsule endoscopy (VCE) characteristics of pediatric HSP patients are rarely reported.MethodsPatients diagnosed with HSP and analyzed by VCE examination at our hospital from February 2010 to January 2020 are enrolled. The clinical features, laboratory findings, and the characteristics of VCE findings are studied.ResultsThere are 30 patients enrolled in this investigation from February 2010 to January 2020. The mean age of these patients is 96.9 ± 35.8 months, and the most frequent finding of VCE is mucosal erosion, which account for 79.3% of the patients, and followed by mucosal erythema or petechia accounted for 69% of the patients. Regarding the disease location detected by endoscopy, jejunum is the most common involved part of the gastrointestinal tract in pediatric HSP patients. All the patients had the jejunum involved except in one patient the VCE did not pass through the pylorus. One third of the patients involved the descending portion of duodenum. No side effect is observed in this study.ConclusionsVCE may be an excellent adjust tool for evaluation of the gastrointestinal tract in children with abdominal symptoms without typical purpura in suspected pediatric HSP patients. VCE appears to be superior to esophagogastroduodenoscopy in detecting small intestinal lesions of HSP and has an excellent safety profile.

Commentary—Update on disorders of the gastrointestinal tract in children, part II

Commentary—Update on disorders of the gastrointestinal tract in children, part II