Gastrofiberscopic findings in children complaining of upper gastrointestinal symptoms

Seo, Jeong Wan

Abstract

A gastrofiberscopic evaluation was performed on 65 children complaining of upper gastrointestinal symptoms who visited the pediatric department of Hanil hospital from March 1991 to September 1992. Gastrofiberscopy was done without local anesthesia of pharynx and heavy sedation. To identify H. pylori infection, biopsy specimen was taken from the gastric antrum since Feb. 1992. The specimens were examined using the rapid urease test and Giemsa stain. The results were as follows: 1) Twenty nine patients were male, 36 patients were female. The frequency of age distribution was 6% in 3~5 years, 42% in 6~10 years and 52% in 11~15 years. The most of cases were between 11~15 years of age(52%). 2) The indications were recurrent abdominal pain(40%), epigastric pain(34%), hematemesis(14%), abnormal UGI series(10%) and severe vomiting(2%) 3) Among 26 patients with recurrent abdominal pain, gastrofiberscopy showed acute superficial gastritis in 6 patients and duodenitis in 4. The rest of the patients were normal(16 patients). With regard to epigastric pain, out of 21 patients 7 showed acute gastritis and 4 patients had duodenitis. The rest 10 patients were normal. Of 9 patients examined endoscopically for upper GI bleeding, no focus of bleeding were identified in 2 patients. The remaining 7 patients were bleeding from acute gastritis (3 patients), gastric ulcer (1), duodenal ulcer (2) and esophageal varix (1). The majority of the patients who had some abnormality on UGI series was endoscopically normal (7/8) and only one patient had duodenitis. The patient with severe vomiting was normal. 4) Among 21 patients H. pylori infection was found in 6 patients (29%). Gastrofiberscopic findings were normal in 4 patients, duodenal ulcer in 1 and acute gastritis in 1 patient. Gastric biopsy findings in H. pylori infected patients were chronic active gastritis in 4 patients and normal in 1 patient. 5) There were no serious complications during the endoscopic procedure. It was concluded that upper gastrointestinal endoscopy was useful means of identifying the upper gastrointestinal pathology in children with upper GI symptoms. As a result of better understanding and technological advances, a changing trend of wider and more rational application of the procedure is evident.