High Incidence of Upper Gastrointestinal Tract Involvement in Children With Crohn Disease

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 777-781
Author(s):  
C. Lenaerts ◽  
C. C. Roy ◽  
M. Vaillancourt ◽  
A. M. Weber ◽  
C. L. Morin ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Gastrointestinal Tract ◽  
Children And Adolescents ◽  
Chronic Ulcerative Colitis ◽  
Crohn Disease ◽  
Bowel Disease ◽  
Upper Gastrointestinal Tract ◽  
Indeterminate Colitis ◽  
Gastrointestinal Lesions ◽  
Upper Gastrointestinal

This retrospective study of Crohn disease in 230 children and adolescents with a mean age of 12.5 years at the time of diagnosis and an average follow-up of 6.6 years showed that 30% had lesions of the esophagus, stomach, and duodenum. Three patients had Crohn disease isolated to the upper gastrointestinal tract. The 169 patients with both small and large bowel disease were at greater risk (33%, P < .05) of having upper gastrointestinal lesions than the 37 with isolated small bowel disease and the 21 with disease limited to the colon and/ or rectum. An aggregate of symptoms and signs more likely present in those with upper gastrointestinal involvement included: dysphagia, pain when eating, nausea and/or vomiting, and aphthous lesions of the mouth. Furthermore, weight loss was more severe and hypoalbuminemia more frequent. Because upper gastrointestinal series x-ray studies failed to detect upper gastrointestinal lesions in 13 patients of 69 of those with upper gastrointestinal disease, endoscopy should be considered in all children and adolescents in whom a diagnosis of Crohn disease is entertained. Endoscopy and biopsy of the upper gastrointestinal tract should be done in any patient with symptoms suggestive of proximal involvement. Finally, in view of the fact that endoscopy established the diagnosis of Crohn disease in five patients previously thought to have chronic ulcerative colitis, the procedure should routinely be performed in all patients with chronic ulcerative colitis or indeterminate colitis before surgery is performed.

scholarly journals Causes of Melena and Effective Examination Strategies in Children

2021 ◽  
Vol 9 ◽  
Author(s):  
Itaru Iwama ◽  
Masashi Yoshida ◽  
Tomoko Hara ◽  
Ryusuke Nambu
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Upper Gastrointestinal Tract ◽  
Common Source ◽  
Abdominal Ultrasonography ◽  
Bleeding Source ◽  
Endoscopic Method ◽  
Gastrointestinal Lesions ◽  
Clinical Records ◽  
Upper Gastrointestinal

Background and Aim: Melena, or tarry black stool, is not a rare symptom encountered in pediatric clinical practice, and the bleeding source varies from the upper gastrointestinal tract to the small intestine. Endoscopy is effective in identifying bleeding, but it does not always identify the source of bleeding. Endoscopic examination in children is commonly challenging, and there are no detailed reports about the causes of melena in children. This observational study aimed to validate the cause of melena in children and to investigate more effective and less burdensome examination methods.Methods: We retrospectively reviewed the clinical records of 55 patients who underwent examination for melena.Results: In this research, 38 patients had underlying diseases such as malignancy and severe mental and physical disorders. The bleeding source was identified in 39 patients. The most common final diagnosis was duodenal ulcer (n = 22), and the other diagnoses were gastric ulcer, esophagitis, and esophageal varices. The upper gastrointestinal tract was the most common source of bleeding (n = 34). In five patients, the bleeding source was the small intestine. Vomiting, abnormal abdominal ultrasonography findings, and a hemoglobin level of ≤ 3 g/dL than the lower normal limit were significant factors indicating that the bleeding source can be found on esophagogastroduodenoscopy.Conclusions: The upper gastrointestinal tract was the most common bleeding source of melena in children. As in adults, esophagogastroduodenoscopy is the primary endoscopic method of choice. Furthermore, small bowel capsule endoscopy may be useful in identifying the bleeding source in children without upper gastrointestinal lesions.

scholarly journals Two Cases of Diffuse Duodenitis Associated with Ulcerative Colitis

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Katsuya Endo ◽  
Masatake Kuroha ◽  
Hisashi Shiga ◽  
Yoichi Kakuta ◽  
Seiichi Takahashi ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Gastrointestinal Tract ◽  
Target Organ ◽  
Upper Gastrointestinal Tract ◽  
Histological Findings ◽  
Gastrointestinal Involvement ◽  
Case Patient ◽  
Free Condition ◽  
Number Of Patients ◽  
Upper Gastrointestinal

The upper gastrointestinal tract is not generally considered a target organ in ulcerative colitis (UC). However, several cases showing upper gastrointestinal involvement in UC have been reported. In this report, we present 2 rare cases of diffuse duodenitis accompanying pancolonic UC. Case patient 1 was a 44-year-old man who developed diffuse duodenitis shortly after colectomy and was successfully treated with mesalazine. Case patient 2 was a 25-year-old woman who developed diffuse duodenitis under a steroid-free condition and was successfully treated with prednisolone. The 2 patients hadHelicobacter pylori-negative duodenitis that resembled colonic lesions of UC in both the endoscopic and histological findings. No evidence of Crohn’s disease was found in these cases. We diagnosed both cases as typical UC-associated diffuse duodenitis. The occurrence of gastrointestinal involvement in UC has been attracting attention because such lesions could potentially open a new window for studying the etiology and pathogenesis of UC. Further studies involving a large number of patients are needed to clarify whether the upper gastrointestinal tract is a target organ in UC.

scholarly journals CORRELATIVE STUDY OF HISTOPATHOLOGICAL DIAGNOSIS WITH CLINICAL & ENDOSCOPIC DIAGNOSIS IN UPPER GASTROINTESTINAL ENDOSCOPIC BIOPSY AT TERTIARY CARE CENTER

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Shana Nikhat Khan ◽  
Sanjeev Narang
Keyword(s):  
Gastrointestinal Tract ◽  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Care Center ◽  
Tertiary Care ◽  
Upper Gastrointestinal Tract ◽  
Histopathological Diagnosis ◽  
Surgical Department ◽  
Gastrointestinal Lesions ◽  
Upper Gastrointestinal

Lesions of Upper gastrointestinal tract (GIT) is commonly seen in surgical department patients. These patients are subjected to endoscopic examination and biopsy is taken for further histopathological diagnosis.  A clinical, endoscopic and histopathological diagnosis is made. This study was done to compare and correlate the results of histopathological diagnosis with endoscopic and clinical findings. Study Designed: A total 50 Upper Gastrointestinal tract biopsy cases received in histopathology lab were analyzed.  Material and Method: All endoscopic biopsies from upper GIT were received and processed. Paraffin blocks were made and sections were cut at 4 microns thickness and stained with routine hematoxylin and eosin stain. Their clinical and endoscopic reports were collected and compared with histopathological diagnosis. Result: After analyzing statistically the data, we found that endoscopy results were better than clinical diagnosis and more closer to histopathological diagnosis. Conclusion: Relation of histopathological diagnosis with endoscopic findings & clinical diagnosis was done in our study. We conclude that endoscopy is incomplete without histopathological examination of biopsy & so, the combinations of both plays an important role in diagnosis & management of upper gastrointestinal tract disorders. Histopathological examination remains the gold standard. Keywords: Histopathology, endoscopy, gastrointestinal lesions.

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