Iwańczak Franciszek, Siedlecka-Dawidko Jolanta, Iwanczak Barbara
Uniwersytet Medyczny im. Piastów Slaskich we Wrocławiu, II Katedra i Klinika Pediatrii, Gastroenterologii i Zywienia.
Pol Merkur Lekarski. 2013 Jul;35(205):14-7.
III Rome Criteria of functional gastrointestinal disorders in children, distinguished the disturbances with abdominal pain, to which irritable bowel syndrome, functional abdominal pains, functional dyspepsia and abdominal migraine were included. THE AIM OF THE STUDY was sonographic assessment of the gallbladder and its contractility in functional abdominal pain and irritable bowel syndrome in children.
The study comprised 96 children aged 6 to 18 years, 59 girls and 37 boys. Depending on diagnosis, the children were divided into three groups. 38 children with functional abdominal pain constituted the first group, 26 children with irritable bowel syndrome were included to the second group, the third group consisted of 32 healthy children (control group). Diagnosis of functional abdominal pain and irritable bowel syndrome was made based on the III Rome Criteria. In irritable bowel syndrome both forms with diarrhea (13) and with constipation (13) were observed. Anatomy and contractility of the gallbladder were assessed by ultrasound examination. The presence of septum, wall thickness, thick bile, vesicle volume in fasting state and 30th and 60th minute after test meal were taken into consideration. Test meal comprised about 15% of caloric requirement of moderate metabolism. Children with bile stones and organic diseases were excluded from the study.
Thickened vesicle wall and thick bile were present more frequently in children with irritable bowel syndrome and functional abdominal pain than in control group (p < 0.02). Fasting vesicle volume was significantly greater in children with functional abdominal pain than in irritable bowel syndrome and control group (p = 0.003, p = 0.05). Vesicle contractility after test meal was greatest in children with functional abdominal pain. Evaluation of diminished (smaller than 30%) and enlarged (greater then 80%) gallbladder contractility at 30th and 60th minute after test meal demonstrated disturbances of contractility in children with irritable bowel syndrome and functional abdominal pain.
In children with functional abdominal pain and irritable bowel syndrome disturbances of gallbladder anatomy, fasting volume and contractility after test meal were demonstrated. The observed disturbances require further studies for explanation of their role in functional gastrointestinal disturbances with abdominal pain in children.
儿童功能性胃肠病的罗马Ⅲ标准区分了伴有腹痛的功能紊乱，其中包括肠易激综合征、功能性腹痛、功能性消化不良和腹型偏头痛。本研究的目的是对儿童功能性腹痛和肠易激综合征患者的胆囊及其收缩功能进行超声评估。
本研究纳入了96名6至18岁的儿童，其中59名女孩，37名男孩。根据诊断结果，将儿童分为三组。第一组为38名功能性腹痛患儿，第二组为26名肠易激综合征患儿，第三组为32名健康儿童（对照组）。功能性腹痛和肠易激综合征的诊断依据罗马Ⅲ标准。在肠易激综合征中，观察到腹泻型（13例）和便秘型（13例）两种类型。通过超声检查评估胆囊的解剖结构和收缩功能。考虑空腹状态下以及试餐后第30分钟和第60分钟时胆囊中隔的存在情况、壁厚度、胆汁浓稠度、胆囊体积。试餐约占中等代谢热量需求的15%。患有胆结石和器质性疾病的儿童被排除在研究之外。
与对照组相比，肠易激综合征和功能性腹痛患儿胆囊壁增厚和胆汁浓稠的情况更为常见（p < 0.02）。功能性腹痛患儿的空腹胆囊体积显著大于肠易激综合征患儿和对照组（p = 0.003，p = 0.05）。试餐后胆囊收缩功能在功能性腹痛患儿中最强。对试餐后第30分钟和第60分钟胆囊收缩功能减弱（小于30%）和增强（大于80%）的评估表明，肠易激综合征和功能性腹痛患儿存在收缩功能紊乱。
在功能性腹痛和肠易激综合征患儿中，观察到胆囊解剖结构、空腹体积和试餐后收缩功能的紊乱。观察到的这些紊乱需要进一步研究以解释它们在儿童伴有腹痛的功能性胃肠紊乱中的作用。
