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Portal Hypertension in Children: A Tertiary Center Experience in Turkey 儿童门静脉高压症:土耳其三级中心的经验
Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.301
Emine Nur Sunar Yayla, Sinan Sarı, Neslihan Gürcan Kaya, Ödül Eğrİtaş Gürkan, Hakan Sözen, İbrahim Onur Özen, Aydın Dalgıç, Buket Dalgıç
Purpose Portal hypertension (PH) and its complications have a significant impact on morbidity and mortality. This study aimed to evaluate the etiology; clinical, laboratory, and endoscopic findings; treatment approaches; long-term outcomes; and prognosis of pediatric PH. Methods This retrospective study included 222 pediatric patients diagnosed with PH between 1998 and 2016, and data encompassing clinical, laboratory, and radiological features; treatments; and complications were analyzed. Results The most common causes of PH were portal vein thrombosis (20.3%), progressive familial intrahepatic cholestasis (18.9%), and biliary atresia (12.2%). Among the enrolled patients, 131 (59.0%) were included in the cirrhotic group and 91 (41.0%) in the non-cirrhotic group. Hepatomegaly and increased transaminase levels were more frequent in the cirrhotic group than in the non-cirrhotic group. Additionally, portal gastropathy, esophageal varices, and variceal bleeding were more frequent in the non-cirrhotic group, whereas ascites, hepatopulmonary syndrome and hepatic encephalopathy were more common in the cirrhotic group. The incidence of hepatomegaly was higher in the presinusoidal group than in the prehepatic group (p<0.001). Hyperbilirubinemia was more frequent in the prehepatic group (p=0.046). The frequency of esophageal varices was similar between the prehepatic and presinusoidal groups; however, variceal bleeding was more frequent in the prehepatic group (p=0.002). Conclusion Extrahepatic portal vein obstruction, genetic-metabolic diseases, and biliary atresia were the most prevalent causes of PH in our country. In patients with PH, hepatomegaly, increased transaminase levels, and synthesis dysfunction were suggestive of cirrhotic PH. Notably, PH in patients without cirrhosis might be more severe than that in those with cirrhosis.
{"title":"Portal Hypertension in Children: A Tertiary Center Experience in Turkey","authors":"Emine Nur Sunar Yayla, Sinan Sarı, Neslihan Gürcan Kaya, Ödül Eğrİtaş Gürkan, Hakan Sözen, İbrahim Onur Özen, Aydın Dalgıç, Buket Dalgıç","doi":"10.5223/pghn.2023.26.6.301","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.6.301","url":null,"abstract":"Purpose Portal hypertension (PH) and its complications have a significant impact on morbidity and mortality. This study aimed to evaluate the etiology; clinical, laboratory, and endoscopic findings; treatment approaches; long-term outcomes; and prognosis of pediatric PH. Methods This retrospective study included 222 pediatric patients diagnosed with PH between 1998 and 2016, and data encompassing clinical, laboratory, and radiological features; treatments; and complications were analyzed. Results The most common causes of PH were portal vein thrombosis (20.3%), progressive familial intrahepatic cholestasis (18.9%), and biliary atresia (12.2%). Among the enrolled patients, 131 (59.0%) were included in the cirrhotic group and 91 (41.0%) in the non-cirrhotic group. Hepatomegaly and increased transaminase levels were more frequent in the cirrhotic group than in the non-cirrhotic group. Additionally, portal gastropathy, esophageal varices, and variceal bleeding were more frequent in the non-cirrhotic group, whereas ascites, hepatopulmonary syndrome and hepatic encephalopathy were more common in the cirrhotic group. The incidence of hepatomegaly was higher in the presinusoidal group than in the prehepatic group (p<0.001). Hyperbilirubinemia was more frequent in the prehepatic group (p=0.046). The frequency of esophageal varices was similar between the prehepatic and presinusoidal groups; however, variceal bleeding was more frequent in the prehepatic group (p=0.002). Conclusion Extrahepatic portal vein obstruction, genetic-metabolic diseases, and biliary atresia were the most prevalent causes of PH in our country. In patients with PH, hepatomegaly, increased transaminase levels, and synthesis dysfunction were suggestive of cirrhotic PH. Notably, PH in patients without cirrhosis might be more severe than that in those with cirrhosis.","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Functional Gastrointestinal Disorders and Abdominal Visceral Fat in Children and Adolescents 儿童和青少年的功能性胃肠疾病和腹部内脏脂肪
Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.338
Chang Yun Kim, Jae Hyuk Hyun, Eell Ryoo
Purpose Few reports have investigated the correlation between functional gastrointestinal disorders (FGIDs) and the degree of obesity in children and adolescents. Thus, this study aimed to examine the relationship between FGIDs and the degree of obesity in children and adolescents. Methods Children and adolescents (<19 years old) who had undergone abdominopelvic computed tomography and had been diagnosed with FGIDs from 2015 to 2016 were included in this retrospective case-control study in a ratio of 1:2. Abdominal visceral fat was measured using an image analysis software. Results The mean age of all 54 FGID patients was 12.9±3.4 years, and the male: female ratio was 1:1.2. We observed no difference in body mass index (BMI) between the FGID and control groups (19.5±4.6 vs. 20.6±4.3 kg/m2, p=0.150). However, the FGID group had less abdominal visceral fat than that of the control group (26.2±20.0 vs. 34.4±26.9 cm2, p=0.048). Boys in the FGID group had lower BMI (18.5±3.5 vs. 20.9±4.3 kg/m2, p=0.019) and less abdominal visceral fat (22.8±15.9 vs. 35.9±31.8 cm2, p=0.020) than those of boys in the control group. However, we found no difference in BMI (20.5±5.3 vs. 20.4±4.2 kg/m2, p=0.960) and abdominal visceral fat (29.0±22.9 vs. 33.1±22.1 cm2, p=0.420) between girls in both groups. Conclusion Our study revealed a difference in the relationship between FGID and the degree of obesity according to sex, which suggests that sex hormones influence the pathogenesis of FGIDs. Multicenter studies with larger cohorts are required to clarify the correlation between FGID subtypes and the degree of obesity.
{"title":"Functional Gastrointestinal Disorders and Abdominal Visceral Fat in Children and Adolescents","authors":"Chang Yun Kim, Jae Hyuk Hyun, Eell Ryoo","doi":"10.5223/pghn.2023.26.6.338","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.6.338","url":null,"abstract":"Purpose Few reports have investigated the correlation between functional gastrointestinal disorders (FGIDs) and the degree of obesity in children and adolescents. Thus, this study aimed to examine the relationship between FGIDs and the degree of obesity in children and adolescents. Methods Children and adolescents (<19 years old) who had undergone abdominopelvic computed tomography and had been diagnosed with FGIDs from 2015 to 2016 were included in this retrospective case-control study in a ratio of 1:2. Abdominal visceral fat was measured using an image analysis software. Results The mean age of all 54 FGID patients was 12.9±3.4 years, and the male: female ratio was 1:1.2. We observed no difference in body mass index (BMI) between the FGID and control groups (19.5±4.6 vs. 20.6±4.3 kg/m2, p=0.150). However, the FGID group had less abdominal visceral fat than that of the control group (26.2±20.0 vs. 34.4±26.9 cm2, p=0.048). Boys in the FGID group had lower BMI (18.5±3.5 vs. 20.9±4.3 kg/m2, p=0.019) and less abdominal visceral fat (22.8±15.9 vs. 35.9±31.8 cm2, p=0.020) than those of boys in the control group. However, we found no difference in BMI (20.5±5.3 vs. 20.4±4.2 kg/m2, p=0.960) and abdominal visceral fat (29.0±22.9 vs. 33.1±22.1 cm2, p=0.420) between girls in both groups. Conclusion Our study revealed a difference in the relationship between FGID and the degree of obesity according to sex, which suggests that sex hormones influence the pathogenesis of FGIDs. Multicenter studies with larger cohorts are required to clarify the correlation between FGID subtypes and the degree of obesity.","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"251 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Growth and Nutritional Biomarkers in Brazilian Infants with Cow’s Milk Allergy at Diagnosis and 18-Month Follow-Up: A Prospective Cohort Study 巴西牛奶过敏婴儿在诊断和18个月随访时的生长和营养生物标志物:一项前瞻性队列研究
Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.355
Anne Jardim-Botelho, Tatiane Graça Martins, Jackeline Motta-Franco, Rosan Meyer, Sarah Cristina Fontes Vieira, Bruna Franca Protásio, Milena Letícia Santos Silva, Rebecca Silveira Pontes, Marcela Barros Barbosa de Oliveira, Ikaro Daniel de Carvalho Barreto, Ricardo Queiroz Gurgel
Purpose This study aimed to describe the growth, body protein status, and micronutrient biomarkers of Brazilian infants with cow’s milk allergy (CMPA) at baseline and at 18 months of follow-up in comparison with their healthy peers. Methods Thirty infants with CMPA younger than six months of age were included in this longitudinal study, and their nutritional status was compared with that of 24 non-allergic age-matched children. Anthropometric measurements were used to assess growth, and blood and urine samples were analyzed for protein and micronutrient status. Mixed linear models adjusted for birth weight, socioeconomic status, infant feeding at baseline, weight-for-age, C-reactive protein, serum albumin, micronutrient dietary supplementation, and salt consumption were employed to evaluate the evolution of nutritional parameters throughout the follow-up period. Results Overall, the mean age of the children at enrolment was 2.9 (standard deviation 1.7) months, and 29 children (53.7%) were male. Infants with CMPA showed a higher prevalence of functional iron depletion (transferrin saturation <20) (p=0.027), lower serum ferritin (p=0.009), and lower urinary iodine (p=0.034) levels than non-allergic children at baseline. Patients with CMPA showed a higher increment in weight-for-age and length-for-age over time than those in the control group (p<0.01). Mixed linear analyses showed a significantly lower increase in serum vitamin B12 (s-B12) (p=0.001) and urinary iodine (p<0.001) concentrations over time compared to the control group. Conclusion Infants with CMPA on a cow’s milk elimination diet had a higher weight and length at 18 months of follow-up but showed signs of inadequate iron, iodine, and B-12 vitamin status.
{"title":"Growth and Nutritional Biomarkers in Brazilian Infants with Cow’s Milk Allergy at Diagnosis and 18-Month Follow-Up: A Prospective Cohort Study","authors":"Anne Jardim-Botelho, Tatiane Graça Martins, Jackeline Motta-Franco, Rosan Meyer, Sarah Cristina Fontes Vieira, Bruna Franca Protásio, Milena Letícia Santos Silva, Rebecca Silveira Pontes, Marcela Barros Barbosa de Oliveira, Ikaro Daniel de Carvalho Barreto, Ricardo Queiroz Gurgel","doi":"10.5223/pghn.2023.26.6.355","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.6.355","url":null,"abstract":"Purpose This study aimed to describe the growth, body protein status, and micronutrient biomarkers of Brazilian infants with cow’s milk allergy (CMPA) at baseline and at 18 months of follow-up in comparison with their healthy peers. Methods Thirty infants with CMPA younger than six months of age were included in this longitudinal study, and their nutritional status was compared with that of 24 non-allergic age-matched children. Anthropometric measurements were used to assess growth, and blood and urine samples were analyzed for protein and micronutrient status. Mixed linear models adjusted for birth weight, socioeconomic status, infant feeding at baseline, weight-for-age, C-reactive protein, serum albumin, micronutrient dietary supplementation, and salt consumption were employed to evaluate the evolution of nutritional parameters throughout the follow-up period. Results Overall, the mean age of the children at enrolment was 2.9 (standard deviation 1.7) months, and 29 children (53.7%) were male. Infants with CMPA showed a higher prevalence of functional iron depletion (transferrin saturation <20) (p=0.027), lower serum ferritin (p=0.009), and lower urinary iodine (p=0.034) levels than non-allergic children at baseline. Patients with CMPA showed a higher increment in weight-for-age and length-for-age over time than those in the control group (p<0.01). Mixed linear analyses showed a significantly lower increase in serum vitamin B12 (s-B12) (p=0.001) and urinary iodine (p<0.001) concentrations over time compared to the control group. Conclusion Infants with CMPA on a cow’s milk elimination diet had a higher weight and length at 18 months of follow-up but showed signs of inadequate iron, iodine, and B-12 vitamin status.","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of the Coronavirus Disease 2019 Pandemic on Pediatric Gastrointestinal Endoscopy: A Questionnaire-based Internet Survey of 162 Institutional Experiences in Asia Pacific 2019冠状病毒病大流行对儿科胃肠内窥镜检查的影响:基于亚太地区162家机构经验的问卷调查
Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.291
Andy Darma, Katsuhiro Arai, Jia-feng Wu, Nuthapong Ukarapol, Shin-ichiro Hagiwara, Seak Hee Oh, Suporn Treepongkaruna
Purpose The impact of coronavirus 2019 (COVID-19) on gastrointestinal (GI) endoscopy procedures in adults has been reported, with a drastic reduction in the number of procedures. However, there are no sufficient data regarding the impact on pediatric GI endoscopy. Here, we aimed to report that impact in the Asia-Pacific region. Methods A questionnaire-based internet survey was conducted from June to November 2021 among pediatric endoscopy institutions in the Asia-Pacific region, with each institution providing a single response. Overall, 25 questions focused on the impact of the number of procedures conducted, the usage of personal protective equipment (PPE), and endoscopy training programs during the pandemic. Results A total of 162 institutions across 13 countries in the Asia-Pacific region participated in the study, and 133 (82.1%) institutions underwent procedure changes since the emergence of COVID-19. The number of esophagogastroduodenoscopy and ileocolonoscopy procedures decreased in 118/133 (88.7%) and 112/133 (84.2%) institutions, respectively. Endoscopy for patient with positive COVID-19 in an emergency or urgent cases still carried out in 102/162 (62.9%) institutions. Screening of COVID-19 for all patients before endoscopy was done across 110/162 (67.9%) institutions. PPE recommendations varied among institutions. Pediatric gastrointestinal endoscopy training programs were discontinued in 127/162 (78.4%) institutions. Conclusion This study reports the impact of the COVID-19 pandemic on pediatric gastrointestinal endoscopy in the Asia-Pacific region. There has been a significant reduction in the number of endoscopic procedures and relevant training programs.
{"title":"Impact of the Coronavirus Disease 2019 Pandemic on Pediatric Gastrointestinal Endoscopy: A Questionnaire-based Internet Survey of 162 Institutional Experiences in Asia Pacific","authors":"Andy Darma, Katsuhiro Arai, Jia-feng Wu, Nuthapong Ukarapol, Shin-ichiro Hagiwara, Seak Hee Oh, Suporn Treepongkaruna","doi":"10.5223/pghn.2023.26.6.291","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.6.291","url":null,"abstract":"Purpose The impact of coronavirus 2019 (COVID-19) on gastrointestinal (GI) endoscopy procedures in adults has been reported, with a drastic reduction in the number of procedures. However, there are no sufficient data regarding the impact on pediatric GI endoscopy. Here, we aimed to report that impact in the Asia-Pacific region. Methods A questionnaire-based internet survey was conducted from June to November 2021 among pediatric endoscopy institutions in the Asia-Pacific region, with each institution providing a single response. Overall, 25 questions focused on the impact of the number of procedures conducted, the usage of personal protective equipment (PPE), and endoscopy training programs during the pandemic. Results A total of 162 institutions across 13 countries in the Asia-Pacific region participated in the study, and 133 (82.1%) institutions underwent procedure changes since the emergence of COVID-19. The number of esophagogastroduodenoscopy and ileocolonoscopy procedures decreased in 118/133 (88.7%) and 112/133 (84.2%) institutions, respectively. Endoscopy for patient with positive COVID-19 in an emergency or urgent cases still carried out in 102/162 (62.9%) institutions. Screening of COVID-19 for all patients before endoscopy was done across 110/162 (67.9%) institutions. PPE recommendations varied among institutions. Pediatric gastrointestinal endoscopy training programs were discontinued in 127/162 (78.4%) institutions. Conclusion This study reports the impact of the COVID-19 pandemic on pediatric gastrointestinal endoscopy in the Asia-Pacific region. There has been a significant reduction in the number of endoscopic procedures and relevant training programs.","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Significance of Triglyceride-to-High-Density Lipoprotein Cholesterol Ratio in Children with Non-Alcoholic Fatty Liver Disease 甘油三酯与高密度脂蛋白胆固醇比值在非酒精性脂肪肝患儿中的意义
Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.312
Hyun Jin Kim
Purpose Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and metabolic syndrome. This study evaluated the significance of markers such as the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio and TG-glucose (TyG) indices in a group of patients with NAFLD. Methods We retrospectively analyzed the data of patients aged 5–18 years diagnosed with NAFLD between January 2014 and January 2021. Results Among the 151 patients with NAFLD, 79.5% were found to be obese, and the mean TG/HDL-C ratio (3.78±2.54 vs. 3.13±2.24) and TyG index (4.69±0.28 vs. 4.56±0.30) were slightly higher in patients with obesity compared to those without obesity. Patients with severe hepatic steatosis had a significantly higher mean TG/HDL-C ratio (4.11±2.16 vs. 3.11±2.30, p=0.035) than those with mild to moderate steatosis. Severe hepatic steatosis grade was defined as an area under the receiver operating characteristic curve of the TG/HDL-C ratio of 0.760 (95% confidence interval, 0.544–0.875), with an optimal cutoff value of 3.37. Conclusion A high TG/HDL-C ratio is associated with severe hepatic steatosis and diabetes mellitus in children with NAFLD. Measurement of this ratio can help clinicians in identifying patients and targeting them for treatment and follow-up.
{"title":"Significance of Triglyceride-to-High-Density Lipoprotein Cholesterol Ratio in Children with Non-Alcoholic Fatty Liver Disease","authors":"Hyun Jin Kim","doi":"10.5223/pghn.2023.26.6.312","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.6.312","url":null,"abstract":"Purpose Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and metabolic syndrome. This study evaluated the significance of markers such as the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio and TG-glucose (TyG) indices in a group of patients with NAFLD. Methods We retrospectively analyzed the data of patients aged 5–18 years diagnosed with NAFLD between January 2014 and January 2021. Results Among the 151 patients with NAFLD, 79.5% were found to be obese, and the mean TG/HDL-C ratio (3.78±2.54 vs. 3.13±2.24) and TyG index (4.69±0.28 vs. 4.56±0.30) were slightly higher in patients with obesity compared to those without obesity. Patients with severe hepatic steatosis had a significantly higher mean TG/HDL-C ratio (4.11±2.16 vs. 3.11±2.30, p=0.035) than those with mild to moderate steatosis. Severe hepatic steatosis grade was defined as an area under the receiver operating characteristic curve of the TG/HDL-C ratio of 0.760 (95% confidence interval, 0.544–0.875), with an optimal cutoff value of 3.37. Conclusion A high TG/HDL-C ratio is associated with severe hepatic steatosis and diabetes mellitus in children with NAFLD. Measurement of this ratio can help clinicians in identifying patients and targeting them for treatment and follow-up.","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"166 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence and Risk Factors of Functional Gastrointestinal Disorders in Infants in Indonesia. 印度尼西亚婴儿功能性胃肠疾病的患病率和危险因素。
IF 1.9 Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.1.58
Lily Arsanti Lestari, Adhyatma Noor Rizal, Wahyu Damayanti, Yulianti Wibowo, Chang Ming, Yvan Vandenplas

Purpose: Information regarding functional gastrointestinal disorders (FGIDs) in infants is currently lacking in Indonesia. This study aimed to describe the prevalence and risk factors of FGIDs in infants aged 6 weeks to 4 months in Indonesia.

Methods: This cross-sectional study of 433 infants was conducted between September 2018 and February 2020. Information on FGIDs was collected using the Infant Gastrointestinal Symptom Questionnaire and the Feeding Practice and Gut Comfort Questionnaire. Adapted Rome IV criteria were used to define the FGIDs.

Results: The prevalence of regurgitation was 26.3%; 16.8% of the infants presented crying-related symptoms and 5.5% exhibited constipation. The statistical analyses revealed that constipation was associated with sex (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.07-7.71; p=0.043), employment of the father (OR, 0.3; 95% CI, 0.12-0.77; p=0.01), and education of the mother (OR, 1.92; 95% CI, 1.07-3.51; p=0.031). Length at birth (OR, 0.74; 95% CI, 0.55-0.99; p=0.042) was associated with constipation. Length at visit (OR, 0.83; 95% CI, 0.76-0.91; p<0.001) was associated with regurgitation, and the weight at visit (OR, 0.58; 95% CI, 0.35-0.96; p=0.038) was associated with crying and/or colic. A history of parental FGIDs was associated with crying-related symptoms (OR, 2.12; 95% CI, 1.23-3.68; p=0.007).

Conclusion: Regurgitation, crying, and constipation are common FGIDs in infants. Some parental and infant characteristics may be predictors for FGIDs. Further investigations are needed to evaluate the clinical relevance of our findings. Understanding the determinants of FGIDs will benefit healthcare professionals and parents to improve infant's quality of life and better manage these condition.

目的:印度尼西亚目前缺乏关于婴儿功能性胃肠疾病(fgid)的信息。本研究旨在描述印度尼西亚6周至4个月婴儿fgid的患病率和危险因素。方法:该横断面研究于2018年9月至2020年2月期间对433名婴儿进行。使用婴儿胃肠道症状问卷和喂养实践与肠道舒适问卷收集fgid信息。采用改编的Rome IV标准来定义fgid。结果:患儿反流发生率为26.3%;16.8%的婴儿出现哭泣相关症状,5.5%出现便秘。统计分析显示,便秘与性别有关(优势比[OR], 2.74;95%置信区间[CI], 1.07-7.71;p=0.043),父亲的就业率(OR, 0.3;95% ci, 0.12-0.77;p=0.01)、母亲的受教育程度(OR, 1.92;95% ci, 1.07-3.51;p = 0.031)。出生时长度(OR, 0.74;95% ci, 0.55-0.99;P =0.042)与便秘有关。访视时长(OR, 0.83;95% ci, 0.76-0.91;Pp =0.038)与哭泣和/或绞痛相关。父母有fgid病史与哭泣相关症状相关(OR, 2.12;95% ci, 1.23-3.68;p = 0.007)。结论:反流、哭闹和便秘是婴儿常见的fgid。一些父母和婴儿的特征可能是fgid的预测因子。需要进一步的研究来评估我们的发现的临床相关性。了解fgid的决定因素将有利于医护人员和家长提高婴儿的生活质量和更好地管理这些情况。
{"title":"Prevalence and Risk Factors of Functional Gastrointestinal Disorders in Infants in Indonesia.","authors":"Lily Arsanti Lestari,&nbsp;Adhyatma Noor Rizal,&nbsp;Wahyu Damayanti,&nbsp;Yulianti Wibowo,&nbsp;Chang Ming,&nbsp;Yvan Vandenplas","doi":"10.5223/pghn.2023.26.1.58","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.1.58","url":null,"abstract":"<p><strong>Purpose: </strong>Information regarding functional gastrointestinal disorders (FGIDs) in infants is currently lacking in Indonesia. This study aimed to describe the prevalence and risk factors of FGIDs in infants aged 6 weeks to 4 months in Indonesia.</p><p><strong>Methods: </strong>This cross-sectional study of 433 infants was conducted between September 2018 and February 2020. Information on FGIDs was collected using the Infant Gastrointestinal Symptom Questionnaire and the Feeding Practice and Gut Comfort Questionnaire. Adapted Rome IV criteria were used to define the FGIDs.</p><p><strong>Results: </strong>The prevalence of regurgitation was 26.3%; 16.8% of the infants presented crying-related symptoms and 5.5% exhibited constipation. The statistical analyses revealed that constipation was associated with sex (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.07-7.71; <i>p</i>=0.043), employment of the father (OR, 0.3; 95% CI, 0.12-0.77; <i>p</i>=0.01), and education of the mother (OR, 1.92; 95% CI, 1.07-3.51; <i>p</i>=0.031). Length at birth (OR, 0.74; 95% CI, 0.55-0.99; <i>p</i>=0.042) was associated with constipation. Length at visit (OR, 0.83; 95% CI, 0.76-0.91; <i>p</i><0.001) was associated with regurgitation, and the weight at visit (OR, 0.58; 95% CI, 0.35-0.96; <i>p</i>=0.038) was associated with crying and/or colic. A history of parental FGIDs was associated with crying-related symptoms (OR, 2.12; 95% CI, 1.23-3.68; <i>p</i>=0.007).</p><p><strong>Conclusion: </strong>Regurgitation, crying, and constipation are common FGIDs in infants. Some parental and infant characteristics may be predictors for FGIDs. Further investigations are needed to evaluate the clinical relevance of our findings. Understanding the determinants of FGIDs will benefit healthcare professionals and parents to improve infant's quality of life and better manage these condition.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"26 1","pages":"58-69"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d8/3d/pghn-26-58.PMC9911174.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9328830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Rising Burden of Psychiatric and Behavioral Disorders and Their Adverse Impact on Health Care Expenditure in Hospitalized Pediatric Patients with Inflammatory Bowel Disease. 儿童炎症性肠病住院患者精神和行为障碍负担的增加及其对医疗保健支出的不利影响
IF 1.9 Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.1.23
Aravind Thavamani, Jasmine Khatana, Krishna Kishore Umapathi, Senthilkumar Sankararaman

Purpose: The incidence and prevalence of inflammatory bowel disease (IBD) are increasing along with an increasing number of patients with comorbid conditions like psychiatric and behavioral disorders, which are independent predictors of quality of life.

Methods: Non-overlapping years (2003-2016) of National Inpatient Sample and Kids Inpatient Database were analyzed to include all IBD-related hospitalizations of patients less than 21 years of age. Patients were analyzed for a concomitant diagnosis of psychiatric/behavioral disorders and were compared with IBD patients without psychiatric/behavioral disorder diagnoses for outcome variables: IBD severity, length of stay and inflation-adjusted hospitalization charges.

Results: Total of 161,294 IBD-related hospitalizations were analyzed and the overall prevalence rate of any psychiatric and behavioral disorders was 15.7%. Prevalence rate increased from 11.3% (2003) to 20.6% (2016), p<0.001. Depression, substance use, and anxiety were the predominant psychiatric disorders. Regression analysis showed patients with severe IBD (odds ratio [OR], 1.57; confidence interval [CI], 1.47-1.67; p<0.001) and intermediate IBD (OR, 1.14; CI, 1.10-1.28, p<0.001) had increased risk of associated psychiatric and behavioral disorders than patients with a low severity IBD. Multivariate analysis showed that psychiatric and behavioral disorders had 1.17 (CI, 1.07-1.28; p<0.001) mean additional days of hospitalization and incurred additional $8473 (CI, 7,520-9,425; p<0.001) of mean hospitalization charges, independent of IBD severity.

Conclusion: Prevalence of psychiatric and behavioral disorders in hospitalized pediatric IBD patients has been significantly increasing over the last two decades, and these disorders were independently associated with prolonged hospital stay, and higher total hospitalization charges.

目的:炎症性肠病(IBD)的发病率和患病率正在增加,同时伴有精神和行为障碍等合并症的患者数量也在增加,这些合并症是生活质量的独立预测因素。方法:分析2003-2016年国家住院样本和儿童住院数据库的非重叠年份,包括所有21岁以下的ibd相关住院患者。对伴有精神/行为障碍诊断的患者进行分析,并将结果变量与没有精神/行为障碍诊断的IBD患者进行比较:IBD严重程度、住院时间和经通货膨胀调整的住院费用。结果:共分析了161,294例ibd相关住院病例,其中任何精神和行为障碍的总体患病率为15.7%。患病率从2003年的11.3%上升到2016年的20.6%。结论:在过去20年里,儿科IBD住院患者中精神和行为障碍的患病率显著上升,这些障碍与住院时间延长和住院总费用增加独立相关。
{"title":"Rising Burden of Psychiatric and Behavioral Disorders and Their Adverse Impact on Health Care Expenditure in Hospitalized Pediatric Patients with Inflammatory Bowel Disease.","authors":"Aravind Thavamani,&nbsp;Jasmine Khatana,&nbsp;Krishna Kishore Umapathi,&nbsp;Senthilkumar Sankararaman","doi":"10.5223/pghn.2023.26.1.23","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.1.23","url":null,"abstract":"<p><strong>Purpose: </strong>The incidence and prevalence of inflammatory bowel disease (IBD) are increasing along with an increasing number of patients with comorbid conditions like psychiatric and behavioral disorders, which are independent predictors of quality of life.</p><p><strong>Methods: </strong>Non-overlapping years (2003-2016) of National Inpatient Sample and Kids Inpatient Database were analyzed to include all IBD-related hospitalizations of patients less than 21 years of age. Patients were analyzed for a concomitant diagnosis of psychiatric/behavioral disorders and were compared with IBD patients without psychiatric/behavioral disorder diagnoses for outcome variables: IBD severity, length of stay and inflation-adjusted hospitalization charges.</p><p><strong>Results: </strong>Total of 161,294 IBD-related hospitalizations were analyzed and the overall prevalence rate of any psychiatric and behavioral disorders was 15.7%. Prevalence rate increased from 11.3% (2003) to 20.6% (2016), <i>p</i><0.001. Depression, substance use, and anxiety were the predominant psychiatric disorders. Regression analysis showed patients with severe IBD (odds ratio [OR], 1.57; confidence interval [CI], 1.47-1.67; <i>p</i><0.001) and intermediate IBD (OR, 1.14; CI, 1.10-1.28, <i>p</i><0.001) had increased risk of associated psychiatric and behavioral disorders than patients with a low severity IBD. Multivariate analysis showed that psychiatric and behavioral disorders had 1.17 (CI, 1.07-1.28; <i>p</i><0.001) mean additional days of hospitalization and incurred additional $8473 (CI, 7,520-9,425; <i>p</i><0.001) of mean hospitalization charges, independent of IBD severity.</p><p><strong>Conclusion: </strong>Prevalence of psychiatric and behavioral disorders in hospitalized pediatric IBD patients has been significantly increasing over the last two decades, and these disorders were independently associated with prolonged hospital stay, and higher total hospitalization charges.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"26 1","pages":"23-33"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/06/a1/pghn-26-23.PMC9911177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10824133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Utility of Subjective Global Nutritional Assessment Tool for the Assessment of Malnutrition in Pediatric Patients with Chronic Liver Disease 主观整体营养评估工具在儿科慢性肝病患者营养不良评估中的应用
Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.346
Anwesha Ray, Srikanta Basu, Praveen Kumar
Purpose Approximately 30% of children with chronic liver disease (CLD) are malnourished. However, proper assessment of their nutritional status is difficult. The subjective global nutritional assessment (SGNA) is a comprehensive approach that uses nutrition-focused history and examination, followed by grading of malnourishment. We aimed to study the prevalence of malnutrition in children with CLD using the SGNA tool. Methods This cross-sectional observational study included patients aged <18 years with CLD. Nutritional assessments were recorded using SGNA tool. Conventional anthropometric measurements were performed and corroborated with nutritional status using SGNA tool. Results A total of 85 children with CLD and mean age of 62 months were enrolled in this study. The prevalence of malnourished children according to SGNA was 34%; 22% were moderately malnourished and 12% were severely malnourished. We found statistically significant differences in anthropometric parameters among the three groups. A moderate degree of agreement was found between SGNA and weight-for-age (W/A) (p=0.020), mid-upper arm circumference (MUAC) (p<0.001), and triceps skin-fold thickness (TSF)-for-age (p=0.029). Furthermore, a fair degree of agreement was found between height-for-age (H/A) (p=0.001) and weight-for-height (W/H) (p<0.001). The sensitivity of W/A for detecting malnutrition was 93%, H/A was 90%, MUAC was 86%, and TSF was 88%. The sensitivity was much lower for W/H and body mass index for age (55% for both). Conclusion In our study, more than one-third of children with CLD were malnourished. Nutritional assessment using SGNA is a reliable method for evaluating nutritional status and is significantly correlated with common anthropometric measurements.
{"title":"Utility of Subjective Global Nutritional Assessment Tool for the Assessment of Malnutrition in Pediatric Patients with Chronic Liver Disease","authors":"Anwesha Ray, Srikanta Basu, Praveen Kumar","doi":"10.5223/pghn.2023.26.6.346","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.6.346","url":null,"abstract":"Purpose Approximately 30% of children with chronic liver disease (CLD) are malnourished. However, proper assessment of their nutritional status is difficult. The subjective global nutritional assessment (SGNA) is a comprehensive approach that uses nutrition-focused history and examination, followed by grading of malnourishment. We aimed to study the prevalence of malnutrition in children with CLD using the SGNA tool. Methods This cross-sectional observational study included patients aged <18 years with CLD. Nutritional assessments were recorded using SGNA tool. Conventional anthropometric measurements were performed and corroborated with nutritional status using SGNA tool. Results A total of 85 children with CLD and mean age of 62 months were enrolled in this study. The prevalence of malnourished children according to SGNA was 34%; 22% were moderately malnourished and 12% were severely malnourished. We found statistically significant differences in anthropometric parameters among the three groups. A moderate degree of agreement was found between SGNA and weight-for-age (W/A) (p=0.020), mid-upper arm circumference (MUAC) (p<0.001), and triceps skin-fold thickness (TSF)-for-age (p=0.029). Furthermore, a fair degree of agreement was found between height-for-age (H/A) (p=0.001) and weight-for-height (W/H) (p<0.001). The sensitivity of W/A for detecting malnutrition was 93%, H/A was 90%, MUAC was 86%, and TSF was 88%. The sensitivity was much lower for W/H and body mass index for age (55% for both). Conclusion In our study, more than one-third of children with CLD were malnourished. Nutritional assessment using SGNA is a reliable method for evaluating nutritional status and is significantly correlated with common anthropometric measurements.","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of Dual-Energy X-ray Absorptiometry in Children with Inflammatory Bowel Disease: A Large Single Centre Study. 双能x线吸收仪在儿童炎症性肠病中的应用:一项大型单中心研究
IF 1.9 Q3 PEDIATRICS Pub Date : 2022-11-01 Epub Date: 2022-11-02 DOI: 10.5223/pghn.2022.25.6.473
Asha Jois, Sajini Perera, Peter Simm, George Alex

Purpose: Low bone mineral density (BMD) is a complication in children with inflammatory bowel disease (IBD). There are limited data evaluating dual-energy x-ray absorptiometry (DXA) as a screening tool for low BMD in children with IBD. We performed a single site retrospective analysis of DXA use.

Methods: Children aged 5-18 years with IBD diagnosed between 2013 to 2017 at the Royal Children's Hospital, Australia, were included. Patient demographics, measures of disease activity, DXA scores, and factors related to BMD were collected.

Results: Over a median follow up of 5.1 (4-6.4) years, 72/239 (30.1%) children underwent DXA, and 28/239 (11.7%) children had a second DXA. Our DXA practice differed to consensus guidelines regarding initial screening based on height and/or body mass index (BMI) z-score (8/17 [47.1%]), and repeat surveillance (13/42 [31.0%]). Children had a median lumbar spine (LS) z-score -0.80 (-1.65-0.075). Children with LS z-score≤-2.0 (n=14) had lower weight (6.57 [1.78-23.7] vs. 51.1 [26.5-68.7], p=0.0002) and height centiles (3.62 [1.17-17.1] vs. 42 [16.9-67.1], p=0.0001), and higher faecal calprotectin (FCP) (3041 [1182-4192] vs. 585 [139-2419], p=0.009) compared to children with LS z-score>-2.0. No fractures were reported. Of 28 children who underwent a second DXA 1.6 (1.1-2.2) years following initial DXA, no significant change in z-scores occurred.

Conclusion: Children with IBD had low BMD. In addition to height centile and weight centile, FCP was associated with lower BMD, and should be considered in DXA screening guidelines. Greater clinician awareness of DXA consensus guidelines is required. Future prospective studies are required.

目的:低骨密度(BMD)是儿童炎症性肠病(IBD)的并发症。评估双能x线吸收仪(DXA)作为IBD儿童低骨密度筛查工具的数据有限。我们对DXA的使用进行了单站点回顾性分析。方法:纳入2013年至2017年在澳大利亚皇家儿童医院诊断为IBD的5-18岁儿童。收集患者人口统计资料、疾病活动度测量、DXA评分和与BMD相关的因素。结果:中位随访5.1(4-6.4)年,72/239(30.1%)名儿童接受了DXA治疗,28/239(11.7%)名儿童进行了第二次DXA治疗。我们的DXA实践不同于基于身高和/或体重指数(BMI) z-score(8/17[47.1%])的初始筛查和重复监测(13/42[31.0%])的共识指南。儿童腰椎中位(LS) z-score为-0.80(-1.65-0.075)。LS z-score≤-2.0的儿童(n=14)体重(6.57[1.78-23.7]比51.1 [26.5-68.7],p=0.0002)、身高(3.62[1.17-17.1]比42 [16.9-67.1],p=0.0001)、粪钙保护蛋白(FCP)(3041[1182-4192]比585 [139-2419],p=0.009)均低于LS z-score>-2.0的儿童。无骨折报告。在首次DXA后1.6(1.1-2.2)年进行第二次DXA的28名儿童中,z分数没有发生显着变化。结论:IBD患儿骨密度低。除了身高百分位数和体重百分位数外,FCP还与较低的骨密度有关,应在DXA筛查指南中予以考虑。需要提高临床医生对DXA共识指南的认识。需要进一步的前瞻性研究。
{"title":"Use of Dual-Energy X-ray Absorptiometry in Children with Inflammatory Bowel Disease: A Large Single Centre Study.","authors":"Asha Jois,&nbsp;Sajini Perera,&nbsp;Peter Simm,&nbsp;George Alex","doi":"10.5223/pghn.2022.25.6.473","DOIUrl":"https://doi.org/10.5223/pghn.2022.25.6.473","url":null,"abstract":"<p><strong>Purpose: </strong>Low bone mineral density (BMD) is a complication in children with inflammatory bowel disease (IBD). There are limited data evaluating dual-energy x-ray absorptiometry (DXA) as a screening tool for low BMD in children with IBD. We performed a single site retrospective analysis of DXA use.</p><p><strong>Methods: </strong>Children aged 5-18 years with IBD diagnosed between 2013 to 2017 at the Royal Children's Hospital, Australia, were included. Patient demographics, measures of disease activity, DXA scores, and factors related to BMD were collected.</p><p><strong>Results: </strong>Over a median follow up of 5.1 (4-6.4) years, 72/239 (30.1%) children underwent DXA, and 28/239 (11.7%) children had a second DXA. Our DXA practice differed to consensus guidelines regarding initial screening based on height and/or body mass index (BMI) z-score (8/17 [47.1%]), and repeat surveillance (13/42 [31.0%]). Children had a median lumbar spine (LS) z-score -0.80 (-1.65-0.075). Children with LS z-score≤-2.0 (n=14) had lower weight (6.57 [1.78-23.7] vs. 51.1 [26.5-68.7], <i>p</i>=0.0002) and height centiles (3.62 [1.17-17.1] vs. 42 [16.9-67.1], <i>p</i>=0.0001), and higher faecal calprotectin (FCP) (3041 [1182-4192] vs. 585 [139-2419], <i>p</i>=0.009) compared to children with LS z-score>-2.0. No fractures were reported. Of 28 children who underwent a second DXA 1.6 (1.1-2.2) years following initial DXA, no significant change in z-scores occurred.</p><p><strong>Conclusion: </strong>Children with IBD had low BMD. In addition to height centile and weight centile, FCP was associated with lower BMD, and should be considered in DXA screening guidelines. Greater clinician awareness of DXA consensus guidelines is required. Future prospective studies are required.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"25 6","pages":"473-480"},"PeriodicalIF":1.9,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/73/pghn-25-473.PMC9679306.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40490659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Postoperative Complications of Esophageal Atresia and Role of Endoscopic Balloon Dilatation in Anastomotic Strictures. 食管闭锁术后并发症及内镜球囊扩张在吻合口狭窄中的作用。
IF 1.9 Q3 PEDIATRICS Pub Date : 2022-11-01 Epub Date: 2022-11-02 DOI: 10.5223/pghn.2022.25.6.453
Jin Young Cho, Mea-Young Chang, Mi Hyeon Gang, Yong Wook Lee, Jun Beom Park, Jae Young Kim, Hyun Jin Kim

Purpose: Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is a congenital anomaly that can cause frequent digestive and nutritional problems, even after repair. The most common complication is anastomotic stricture, for which reoperation or balloon dilatation is performed. This study aimed to evaluate the postoperative complications of EA and the role of endoscopic balloon dilatation (EBD) in cases of anastomotic stricture.

Methods: We retrospectively analyzed patients diagnosed with EA with or without TEF between January 2000 and February 2021. Patients' baseline characteristics, associated anomalies, and postoperative complications were reviewed.

Results: Among 26 patients, 14 (53.8%) were male, 12 (46.2%) had coexisting anomalies, and the median follow-up was 6.1 years (range, 1.2-15.7 years). In univariate analysis, prematurity, low birth weight, and long-gap EA were associated with postoperative complications in 12 (46.2%) patients. Among the 10 (38.5%) patients with anastomotic stricture, nine (90.0%) required EBD. Regarding the first EBD, it was performed at a median of 3.3 months (range, 1.2-7.6 months) post-repair, while the average patient weight was 4.6 kg. The mean diameter ranged from 3.3 to 9.1 mm without major complications. In univariate analysis, long-gap EA alone was significantly associated with EBD.

Conclusion: Approximately half of the patients experienced complications after EA repair. In particular, patients with a long-gap EA had a significantly increased risk of complications, such as anastomotic strictures. EBD can be safely used, even in infants.

目的:食管闭锁(EA)伴或不伴气管食管瘘(TEF)是一种先天性异常,即使在修复后也会引起频繁的消化和营养问题。最常见的并发症是吻合口狭窄,需要再次手术或球囊扩张。本研究旨在探讨内镜下球囊扩张术(EBD)在吻合口狭窄病例中的作用及术后并发症。方法:回顾性分析2000年1月至2021年2月期间诊断为EA伴或不伴TEF的患者。回顾了患者的基线特征、相关异常和术后并发症。结果:26例患者中,男性14例(53.8%),并发畸形12例(46.2%),中位随访6.1年(范围1.2 ~ 15.7年)。在单因素分析中,早产、低出生体重和长间隙EA与12例(46.2%)患者的术后并发症相关。吻合口狭窄10例(38.5%)中9例(90.0%)需行EBD。第一例EBD手术的中位时间为修复后3.3个月(1.2-7.6个月),患者平均体重为4.6 kg。平均直径3.3 ~ 9.1 mm,无重大并发症。在单变量分析中,长间隙EA单独与EBD显著相关。结论:大约一半的患者在EA修复后出现并发症。特别是,长间隙EA患者发生吻合口狭窄等并发症的风险显著增加。EBD可以安全使用,即使对婴儿也是如此。
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Pediatric Gastroenterology, Hepatology & Nutrition
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