Kim Yong Joo, Shin Eun Jung, Kim Nam Su, Lee Young Ho, Nam Eun Woo
Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2015 Dec;18(4):261-7. doi: 10.5223/pghn.2015.18.4.261. Epub 2015 Dec 23.
Pediatric chest pain is considered to be idiopathic or caused by benign diseases. This study was to find out how much upper gastrointestinal (UGI) diseases are major causes of chest pain in pediatric patients.
The records of 75 children (42 boys and 33 girls, aged 3-17 years old) who have presented with mainly chest pain from January 1995 to March 2015 were retrospectively reviewed. Chest X-ray and electrocardiography (ECG) were performed in all aptients. Further cardiologic and gastrointestinal (GI) evaluations were performed in indicated patients.
Chest pain was most common in the children of 6 and 9 to 14 years old. Esopha-gogastric diseases were unexpectedly the most common direct causes of the chest pain, the next are idiopathic, cardiac diseases, chest trauma, respiratory disease, and psychosomatic disease. Even though 21 showed abnormal ECG findings and 7 showed abnormalities on echocardiography, cardiac diseases were determined to be the direct causes only in 9. UGI endoscopy was performed in 57 cases, and esophago-gastric diseases which thereafter were thought to be causative diseases were 48 cases. The mean age of the children with esophago-gastric diseases were different with marginal significance from that of the other children with chest pain not related with esophago-gastric diseases. All the 48 children diagnosed with treated with GI medicines based on the diagnosis, and 37 cases (77.1%) subsequently showed clinical improvement.
Diagnostic approaches to find out esophageal and gastric diseases in children with chest pain are important as well as cardiac and respiratory investigations.
小儿胸痛被认为是特发性的或由良性疾病引起。本研究旨在查明上消化道（UGI）疾病在小儿胸痛患者中作为主要病因的比例。
回顾性分析1995年1月至2015年3月期间以胸痛为主诉就诊的75例儿童（42例男孩，33例女孩，年龄3 - 17岁）的病历。所有患者均进行了胸部X线和心电图（ECG）检查。对有指征的患者进行了进一步的心脏和胃肠道（GI）评估。
胸痛在6岁以及9至14岁的儿童中最为常见。食管胃疾病出人意料地是胸痛最常见的直接病因，其次是特发性、心脏疾病、胸部创伤、呼吸系统疾病和心身疾病。尽管21例心电图检查结果异常，7例超声心动图检查有异常，但仅9例被确定心脏疾病为直接病因。57例患者进行了上消化道内镜检查，其中48例此后被认为食管胃疾病是病因。患有食管胃疾病的儿童平均年龄与其他非食管胃相关胸痛儿童的平均年龄有边缘性差异。所有48例诊断为食管胃疾病的儿童均根据诊断接受了胃肠道药物治疗，37例（77.1%）随后临床症状改善。
对于胸痛儿童，查明食管和胃疾病的诊断方法以及心脏和呼吸方面的检查都很重要。
