Abstract
Amaç: Çocuklarda özofagus patolojilerinin sıklığı, bu hastalıkların yaş, cinsiyet ve semptomlarla ilişkisini içeren veriler sınırlıdır. Çalışmanın amacı, çocuklardaki özofagus patolojilerinin sıklığının, etiyolojisinin, endoskopik ve histopatolojik özelliklerinin incelenmesidir.Gereç ve Yöntemler: Birimimizde Mayıs 2009 - Haziran 2015 tarihleri arasında özofagogastroduodenoskopi yapılmış 1-17 yaş aralığında hastalar retrospektif olarak incelendi (n=3081). Hastaların dosya bilgilerinden yaşı, cinsiyeti, şikayetleri ve endoskopik bulguları kaydedildi. İstatiksel değerlendirmede iki grup karşılaştırmalarında normal dağılım gösteren değişkenler için Bağımsız İki Örnek t testi, normal dağılım göstermeyen değişkenler için Mann-Whitney U testi, kategorik değişkenlerin karşılaştırılmasında Ki-kare testi kullanıldı.Bulgular: Toplam 335 hastanın (%10.8) özofagusunda patoloji mevcuttu (205 hastada endoskopik, 12 hastada histopatolojik, 118 hastada hem endoskopik hem de histopatolojik). On yaşının üzerindeki hastalarda özofagus patolojisinin daha sık görüldüğü tespit edildi (p<0.001, OR: 1.65, %95 CI: 1.31-2.08). Reflü şikayeti (89 hasta, %26.5, p<0.001, OR: 7.58, %95 CI: 5.61-10.25) ve disfajisi (10 hasta, %2.9, p<0.001, OR: 7.01, %95 Cl: 3.00-16.35) olan hastalarda özofagusta patoloji saptanma oranının daha fazla olduğu saptandı. Hiatal hernisi olan tüm hastalarda (n=8) histopatolojik anormallik bulunurken, endoskopik olarak yüksek evre özofajit olanlarda daha sık histopatolojik anormallik olduğu tespit edildi.Sonuç: Çalışmamızda, 10 yaşın üzerinde, reflü şikayetleri ve disfajisi olan hastalarda özofagogastroduodenoskopinin tanısal önemi olduğu ve endoskopik olarak saptanan yüksek evre özofajit ile hiatal herni varlığında histopatolojik anormalliğin daha sık olduğu tespit edilmiştir.
References
- Noble AJ, Drouin E, Tamblyn R. Design of predictive models for positive outcomes of upper and lower gastrointestinal endoscopies in children and adolescents. J Pediatr Gastroenterol Nutr 2008;46: 409-13.
- Liacouras CA, Furuta GT, Hirano I, Atkins D, Attwood SE, Bonis PA, et al. Eosinophilic esophagitis: Updated consensus recommendations for children and adults. J Allergy Clin Immunol 2011;128:3-20.
- Dahms BB. Reflux esophagitis: Sequelae and differential diagnosis in infants and children including eosinophilic esophagitis. Pediatr Dev Pathol 2004;7:5-16.
- Dent J. Microscopic esophageal mucosal injury in nonerosive reflux disease. Clin Gastroenterol Hepatol 2007;5:4-16.
- Chadwick LM, Kurinczuk JJ, Hallam LA, Brennan BA, Forbes D. Clinical and endoscopic predictors of histological oesophagitis in infants. J Paediatr Child Health 1997;33:388-93.
- Gordon C, Kang JY, Neild PJ, Maxwell JD. The role of the hiatus hernia in gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2004;20:719-32.
- Scarpato E, D’Armiento M, Martinelli M, Mancusi V, Campione S, Alessandrella A, et al. Impact of hiatal hernia on pediatric dyspeptic symptoms. J Pediatr Gastroenterol Nutr 2014; 59:795-8.
- Ruigo`mez A, Wallander MA, Lundborg P, Johansson S, Rodriguez LA. Gastroesophageal reflux disease in children and adolescents in primary care. Scand J Gastroenterol 2010;45:139–46.
Abstract
Objective: Data concerning the prevalence of esophageal pathologies in children, and their relations with age and sex and symptoms, are limited. The purpose of this study was to investigate the prevalence, etiology and endoscopic and histopathological characteristics of esophageal pathologies in children.Material and Methods: Patients aged 1-17 and undergoing esophagogastroduodenoscopy in our unit between May 2009 and June 2015 were investigated retrospectively (n=3081). Patients’ ages, sex, symptoms and endoscopic findings were recorded from their medical files. At statistical analysis, the Independent Two Sample t test was used for normally distributed variables in two-group comparisons and the Mann-Whitney U test for non-normally distributed variables. The chi square test was used to compare categoric variables.results: Pathology was present in the esophagus of 335 patients (10.8%) (endoscopic in 205, histopathological in 12 and both endoscopic and histopathological in 118). Esophageal pathology was more common in patients aged over 10 (p<0.001, OR: 1.65, 95% CI: 1.31-2.08). A higher prevalence of pathology in the esophagus was determined in patients with reflux (89, 26.5%, p<0.001, OR: 7.58, 95% CI: 5.61-10.25) and dysphagia (10, 2.9%, p<0.001, OR: 7.01, %95 Cl: 3.00-16.35). Histopathological abnormality was determined in all patients with hiatal hernia (n=8), and histopathological abnormality was also more common with high-grade esophagitis determined endoscopically. conclusion: This study revealed the diagnostic importance of esophagogastroduodenoscopy in patients aged over 10 with reflux and dysphagia, and that histopathological anomalies are more common in the presence of hiatal hernia and high-grade esophagitis determined endoscopically
References
- Noble AJ, Drouin E, Tamblyn R. Design of predictive models for positive outcomes of upper and lower gastrointestinal endoscopies in children and adolescents. J Pediatr Gastroenterol Nutr 2008;46: 409-13.
- Liacouras CA, Furuta GT, Hirano I, Atkins D, Attwood SE, Bonis PA, et al. Eosinophilic esophagitis: Updated consensus recommendations for children and adults. J Allergy Clin Immunol 2011;128:3-20.
- Dahms BB. Reflux esophagitis: Sequelae and differential diagnosis in infants and children including eosinophilic esophagitis. Pediatr Dev Pathol 2004;7:5-16.
- Dent J. Microscopic esophageal mucosal injury in nonerosive reflux disease. Clin Gastroenterol Hepatol 2007;5:4-16.
- Chadwick LM, Kurinczuk JJ, Hallam LA, Brennan BA, Forbes D. Clinical and endoscopic predictors of histological oesophagitis in infants. J Paediatr Child Health 1997;33:388-93.
- Gordon C, Kang JY, Neild PJ, Maxwell JD. The role of the hiatus hernia in gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2004;20:719-32.
- Scarpato E, D’Armiento M, Martinelli M, Mancusi V, Campione S, Alessandrella A, et al. Impact of hiatal hernia on pediatric dyspeptic symptoms. J Pediatr Gastroenterol Nutr 2014; 59:795-8.
- Ruigo`mez A, Wallander MA, Lundborg P, Johansson S, Rodriguez LA. Gastroesophageal reflux disease in children and adolescents in primary care. Scand J Gastroenterol 2010;45:139–46.
Details
| Other ID | JA26MM98NP |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | April 1, 2017 |
| Submission Date | April 1, 2017 |
| Published in Issue | Year 2017 Volume: 11 Issue: 1 |
The publication language of Turkish Journal of Pediatric Disease is English.
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