Endoscopic diagnosis in a Tunisian paediatric population with upper gastrointestinal bleeding (uGIB)

##plugins.themes.academic_pro.article.sidebar##

Published Dec 10, 2013
Download
pdf
Vol. 91 No. 11 (2013): Issue Nov 2013

##plugins.themes.academic_pro.article.main##

Sonia Mazigh Mrad
Samir Boukthir
Ines Brini
Selma Hachicha
Azza Samoud

Abstract

Background: Esophagogastroduodenoscopy (EGD) is currently considered the first line diagnostic procedure chosen for Upper Gastrointestinal Bleeding (UGIB) since 1970. However, studies are still limited in our country.
aim: Finding out the most common causes of UGIB in children and whether the causes differed according to age in developing and developed countries.
methods: A retrospective review of the medical records of children referred to the Paediatric Gastroenterology Department of The Tunis Hospital of Children between January 1998 and December 2006 for upper gastrointestinal bleeding. The children were divided into three groups; G1: neonates; G2: infants; G 3: children and adolescents.
results: The study involved 614 endoscopies. The aetiology was not ascertained in 20.68%of cases. G1 included 125 newborns: 24 with no identified causes, 97 mucosal lesions (isolated or associated); two ulcers and two tumours. G2 and G3 included respectively 205 infants and 289 children. Toxic drug intake was recorded in 140 out of 489 patients. Endoscopy was normal in 101 cases. Peptic oesophagitis was recorded in 57/205 (27.8%) of G2 infants versus 52/284 (10%) of G3 children (p=0.015). Gastritis was recorded in 164/284 (55.6%) of G2 infants versus 86/205 (41.9%) of G3 children (p≤0.001). Peptic ulcers were reported in ten boys. Mallory Weiss tears and Variceal lesions were found in respectively eleven and ten cases.
Conclusion: Aetiologies of UGIB in children in Tunisia varied according to age and geographic areas.

Keywords:

Children, endoscopic diagnosis, upper gastrointestinal bleeding.

##plugins.themes.academic_pro.article.details##

References

  1. Franciosi JP, Fiorino K, Ruchelli E, et al. Changing Indications for Upper Endoscopy in Children during a 20-year period.J Pediatr Gastroenterol Nutr 2010;51: 443-47.
  2. Bhatia V,Lodha R. Upper Gastrointestinal Bleeding. Indian J Pediatr 2011; 78:227-33.
  3. El Mouzan MI, Abdullah AM, Al-Mofleh IA.Yield of endoscopy in children with hematemesis.Trop Gastroenterol 2004; 25:44-6.
  4. Mittal SK, Kalra KK, Aggarwal V.Diagnostic upper GI endoscopy for hemetemesis in children: experience from a paediatric gastroenterology centre in north India. Indian J Pediatr 1994; 6:651-54.
  5. Dehghani SM, Haghighat M, Hadi Imanieh M, Reza M. Upper Gastrointestinal Bleeding in Children in Southern Iran. Indian J Pediatr 2009; 76:635-38.
  6. Grimaldi-Bensouda L,Abenhaim L, Michaud L, et al.Clinical features and risk factors for upper gastrointestinal bleeding in children: a case-crossover study.Eur J Clin Pharmacol 2010; 66:831-837.
  7. Huang IF, Wu TC, Wang KS, Hwang B, Hsieh KS. Upper gastrointestinal endoscopy in children with upper gastrointestinal bleeding. J Chin Med Assoc 2003; 66:271-75.
  8. Cleveland K, Ahmad N, Bishop P, Nowicki M. Upper gastrointestinal bleeding in children: an 11-year retrospective endoscopic investigation. World J Pediatr 2012; 8: 123-28.
  9. Benhamou PH, Francoual C, Glangeaud MC, Barette A, Dupont C, Bréart G.Risk factors for severe oesophageal and gastric lesions in term neonates: a case-control study.Groupe Francophone d'Hépato-Gastroentérologie et Nutrition Pédiatrique.J Pediatr Gastroenterol Nutr 2000; 31:377-80
  10. Herman TE, Siegel MJ. Congenital gastric teratoma. J Perinatol 2008; 28:786-7.
  11. Hansen LF, Wewer V, Pedersen SA, Matzen P, Paerregaard A. Severe blue rubber bleb nevus syndrome in a neonate. Eur J Pediatr Surg 2009; 19:47-49.
  12. Bacchini PL, Romanini E, Magnani C, De'Angelis GL, Bevilacqua G. Apparent life threatening event and gastric antral ulcer in a full-term infant: any possible relationship?Acta Biomed 2010; 81:144-6.
  13. Skinner S, Naqvi M, Biskinis EK. Gastric ulcer presenting as gastroesophageal reflux and apnea in a term neonate. Tex Med 1998; 94:57-8.
  14. Lazzaroni M, Petrillo M, Tornaghi R, et al .Upper GI bleeding in healthy full-term infants: a case-control study.Am J Gastroenterol 2002; 97:89-94.
  15. Machado RS, Kawakami E, Goshima S, Patricio FR, Fagundes - Neto U. Hemorrhagic gastritis, cow's milk allergy, infant. J Pediatr (Rio J) 2003; 79:363-8.
  16. Boukthir S, Mazigh Mrad S, Ben Nasr S et al. Activité endoscopique digestive interventionnelle chez l'enfant.Tunis Med 2010; 88:920- 23.
  17. Mazigh Mrad S, Boukthir S, Gharsallah L et al.Helicobacter pylori infection in childhood revealed by hematemesis: endoscopic and pathologic patterns. Tunis Med 2007; 85:930-4.
  18. Kalach N, Papadopoulos S, Asmar E, et al. In French Children, Primary Gastritis Is More Frequent Than Helicobacter pylori gastritis. Dig Dis Sci 2009; 54:1958-1965.
  19. Boukthir S , Mazigh Mrad S, Kalach N, Bouyahya O, Sammoud A .The effect of non-steroidal anti-inflammatory drugs and Helicobacter pylori infection on the gastric mucosa in children with upper gastrointestinal bleeding. Pediatr Surg Int 2010; 26:227-230.
  20. Roma E, Kafritsa Y, Panayiotou J, Liakou R, Constantopoulos A. Is peptic ulcer a common cause of upper gastrointestinal symptoms? Eur J Pediatr 2001; 160: 497-500.
  21. El Mouzan MI, Abdullah AM. Peptic Ulcer Disease in Children and Adolescents. J Trop Pediatr 2004; 50: 328-329.