Karim B
Associate Professor, Paediatric Gastroenterology and Nutrition, BSMMU, Shahabag, Dhaka, Bangladesh.
Mymensingh Med J. 2003 Jul;12(2):124-7.
Upper gastrointestinal endoscopy has changed the management of upper gastrointestinal problems in children. The aim of this communication is to share our experience with 153 cases on whom upper gastrointestinal endoscopy was done over a period of 24 months at a paediatric gastroenterology unit of a tertiary care hospital of Dhaka, Bangladesh. Children who attended the department with various gastrointestinal problems are the subjects of this paper. Intravenous midazolam and 10% pharyngeal xylocain were used in majority of cases for sedating the children. The ages of the children were between 15 months to 15 years (9.41+/- 3.22 years). The positive diagnostic yield was 92 out of 153 cases (60.1%). The major indication for doing endoscopy in the present series was recurrent abdominal pain (51.6%), followed by upper gastrointestinal bleeding (28.8%). Combining histopathological findings and CLO/rapid urease tests the overall positive yield of recurrent abdominal pain was 45 out of 79 (57%). The sources of upper gastrointestinal bleeding could be identified in 79.5% cases. Esophageal varices indicating portal hypertension were found in 62.5% children who were endoscoped for unexplained splenomegaly with or without ascitis. Endoscopy has become a safe and valuable procedure in the management of upper gastrointestinal problems in children and gastric antral biopsy has increased the positive diagnostic yield of recurrent abdominal pain in the studied children.
上消化道内镜检查改变了儿童上消化道疾病的治疗方式。本文旨在分享我们在孟加拉国达卡一家三级护理医院的儿科胃肠病科，对153例在24个月内接受上消化道内镜检查的患儿的经验。本文的研究对象是因各种胃肠道问题前来该科室就诊的儿童。大多数病例使用静脉注射咪达唑仑和10%的咽部利多卡因对儿童进行镇静。患儿年龄在15个月至15岁之间（平均年龄9.41±3.22岁）。153例病例中有92例诊断阳性（阳性率60.1%）。本系列中进行内镜检查的主要指征是反复腹痛（51.6%），其次是上消化道出血（28.8%）。结合组织病理学检查结果和CLO/快速尿素酶试验，79例反复腹痛患儿中总体阳性率为45例（57%）。79.5%的上消化道出血病例可以明确出血来源。在因不明原因脾肿大伴或不伴腹水而接受内镜检查的儿童中，62.5%发现有提示门静脉高压的食管静脉曲张。内镜检查已成为儿童上消化道疾病治疗中一种安全且有价值的方法，胃窦活检提高了本研究中反复腹痛患儿的诊断阳性率。
