Upper Gastrointestinal Endoscopy in Children’s Abdominal Pains in Ivory Coast

Since a longtime considered as functional and psychological, children’s abdominal pains (CAP) is a public health problem. Advances in digestive endoscopy and Helicobacter pylori (H. pylori) discovery have reignited the debate of the organicity of CAP. The aim of this study is to determine the diagnosis rentability of upper gastrointestinal endoscopy (UGIE) in CAP in Ivory Coast. Patients and Methods: This a retrospective analytical study based on reports of UGIE performed in 2 university hospital and 3 private clinics of Abidjan from march 2007 to march 2016. The children (from 1 day to 15 years) in which UGIE were performed for abdominal pains were included in the study. Results: 116 UGIE were performed in children for abdominal pains during the study period. Epigastric pain was the main indication of UGIE (88%). The diagnosis rentability of UGIE was more than 70% in this study. The main anomalies observed in UGIE were gastropathies. Ulcers were rarely found. Conclusion: UGIE play an important diagnosis role in CAP in Ivory Coast. However gastric biopsies for Helicobacter pylori research are not common practice in our country.

Extralobar pulmonary sequestration in children with abdominal pain:Four case reports

BACKGROUND Extralobar pulmonary sequestration(ELS)with torsion is extremely rare,consequently,the diagnosis of ELS with torsion in children presents a challenge for clinicians.Herein,we report four cases of ELS with torsion that presented with abdominal pain,and further review the relevant literature to summarize the clinical features.CASE SUMMARY Four children presented to our department with abdominal pain.All underwent chest computed tomography,which revealed an intrathoracic soft tissue mass with pleural effusion.All four children underwent thoracoscopic resection of the identified pulmonary sequestration,and the vascular pedicle was clipped and excised.None of the patients experienced any postoperative complications.CONCLUSION Clinicians should consider the possibility of ELS with torsion in children presenting with abdominal pain as the chief complaint.

Glucomannan for abdominal pain-related functional gastrointestinal disorders in children:A randomized trial

AIM:To assess the efficacy of glucomannan(GNN) as the sole treatment for abdominal pain-related functional gastrointestinal disorders(FGIDs).METHODS:We conducted a double-blind,placebocontrolled,randomized trial.Patients were recruited among children referred to the Department of Paediatrics,Medical University of Warsaw.Included in the study were children aged 7-17 years with abdominal pain-related FGIDs classified according to the Rome Ⅲ diagnostic criteria.The children were randomly assigned to receive GNN,a polysaccharide of 1,4-D-glucose and D-mannose,a soluble fiber from the Japanese Konjac plant,at a dosage of 2.52 g/d(1 sachet of 1.26 g 2 times a day),or a comparable placebo(maltodextrin) at the same dosage.The content of each sachet was dissolved in approximately 125 mL of fluid and was consumed twice daily for 4 wk.RESULTS:Of the 89 eligible children,84(94%) completed the study."No pain" and "treatment success"(defined as no pain or a decrease ≥ 2/6 points on the FACES Pain Scale Revised) were similar in the GNN(n = 41) and placebo(n = 43) groups [no pain(12/41 vs 6/43,respectively;RR = 2.1,95%CI:0.87-5.07) as well as treatment success(23/41 vs 20/43;RR = 1.2,95%CI:0.79-1.83)].No significant differences between the groups were observed in the secondary outcomes,such as abdominal cramps,abdominal bloating/gassiness,episodes of nausea or vomiting,or a changed in stool consistency.GNN demonstrated no significant influence on the number of children requiring rescue therapy,school absenteeism,or daily activities.CONCLUSION:In our setting,GNN,as dosed in this study,was no more effective than the placebo in achieving therapeutic success in the management of FGIDs in children.

Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children

BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic procedures.Gastroscopy is the gold standard for the diagnosis of peptic ulcer,but it is an invasive procedure.Gastrointestinal contrast-enhanced ultrasonography(CEUS)has the advantages of being painless,noninvasive,nonradioactive,easy to use,and safe.AIM To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children.METHODS We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022.All children were examined by routine ultrasound,gastrointestinal CEUS,and gastroscopy.The pathological results of gastroscopy were taken as the gold standard.Routine ultrasonography was performed before gastrointestinal CEUS.Conventional ultrasound showed the thickness of the gastroduodenal wall,gastric peristalsis,and the adjacent organs and tissues around the abdominal cavity.Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall;the size,location and shape of the ulcer;gastric peristalsis;and adjacent organs and tissues around the abdominal cavity.The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS.All children received informed consent from their guardians for CEUS.This study was reviewed and approved by the hospital medical ethics committee.RESULTS Among the 43 children,17(15 male,2 female)were diagnosed with peptic ulcer by gastroscopy.There were 26 children with nonpeptic ulcer.There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound.The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1%(34/43),which was significantly different from that of gastroscopy(P=0.033).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low.Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS.The diagnostic coincidence rate of peptic ulcer in children was 95.3%(41/43).There was no significant difference between CEUS and gastroscopy(P=0.655).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high.CONCLUSION Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children,and can be used as a preliminary examination method.

Association between functional abdominal pain disorders and asthma in adolescents: A cross-sectional study

AIM To find the association between asthma and different types of functional abdominal pain disorders(FAPDs) among teenagers. METHOD A cross-sectional study was conducted among 13 to 15-year-old children from six randomly selected schools in Anuradhapura district of Sri Lanka. Data were collected using translated and validated selfadministered questionnaires(Rome Ⅲ questionnaire, International Study on Asthma and Allergies in Childhood questionnaire, and Pediatric Quality of Life Inventory 4.0) and administered under an examination setting after obtaining parental consent and assent.RESULTS Of the 1101 children included in the analysis, 157(14.3%) had asthma and 101(9.2%) had at least one FAPDs. Of children with asthma, 19.1% had at least one type of FAPDs. Prevalence rates of functional abdominal pain(FAP)(8.9% vs 3.3% in nonasthmatics), functional dyspepsia(FD)(2.5% vs 0.7%), and abdominal migraine(AM)(3.2% vs 0.4%) were higher in those with asthma(P < 0.05, multiple logistic regression analysis), but not in those with irritable bowel syndrome(4.5% vs 3.1%, P = 0.2). Severe abdominal pain(10.8% vs 4.6%), bloating(16.6% vs 9.6%), nausea(6.4% vs 2.9%), and anorexia(24.2% vs 16.2%) were more prevalent among asthmatics(P < 0.05). Lower gastrointestinal symptoms did not show a significant difference. Scores obtained for health related quality of life(HRQoL) were lower in those with asthma and FAPDs(P < 0.05, unpaired t-test).CONCLUSION Asthma is associated with three different types of FAPDs, namely, FD, AM, and FAP. HRQoL is significantly impaired in teenagers with asthma and FAPDs.

The importance of visualization of appendix on abdominal ultrasound for the diagnosis of appendicitis in children: A quality assessment review

BACKGROUND:Ultrasound has the first line investigation role in the diagnosis of acute appendicitis in children.The purpose of this study was to perform a quality assessment review on the visualization rate of appendix on ultrasound in children in the community hospital setting.METHODS:A retrospective chart review of the abdominal ultrasound findings for the visualization of the appendix was performed on paediatric patients ranging from 5 to 18 years.Data were collected from the two community hospitals of Toronto by using hospital electronic medical record for the ultrasound findings in patients presented with abdominal pain.RESULTS:Data from two community hospitals indicated visualization rate of the appendix as 11.0%and 23.2%for site 1 and site 2 respectively.In cases where the ultrasound was repeated the visualization rate remains the same.A two-proportion z-test was performed to find whether the visualization of appendix increases the likelihood of diagnosing appendicitis.The results revealed that the visualization of an appendix(P=0.52),significantly improved the diagnosis of appendicitis(z=34,P<0.001).CONCLUSION:Visualization of an appendix on ultrasound increases the likelihood of correctly diagnosing appendicitis.In our study,we found low visualization rate of appendix on ultrasound that could be the result of many factors that contribute towards the low visualization rate of an appendix on ultrasound.Hence,the challenges in identifying appendix should be minimized to improve the visualization and diagnosis of appendicitis on ultrasound.

Irritable bowel syndrome in children: Pathogenesis, diagnosis and evidence-based treatment

Irritable bowel syndrome (IBS) is the commonest cause of recurrent abdominal pain (RAP) in children in both more developed and developing parts of the world. It is defined by the Rome III criteria for functional gastrointestinal disorders. It is characterized by abdominal pain that is improved by defecation and whose onset is associated with a change in stool form and or frequency and is not explained by structural or biochemical abnormalities. It is estimated that 10%-15% of older children and adolescents suffer from IBS. IBS can be considered to be a brain-gut disorder possibly due to complex interaction between environmental and hereditary factors. The diagnosis of IBS is made based on the Rome III criteria together with ruling out organic causes of RAP in children such as inflammatory bowel disease and celiac disease. Once the diagnosis of IBS is made, it is important to explain to the parents (and children) that there is no serious underlying disease. This reassurance may be effective treatment in a large number of cases. Lifestyle modifications, stress management, dietary interventions and probiotics may be beneficial in some cases. Although there is limited evidence for efficacy of pharmacological therapies such as antispasmodics and antidiarrheals; these have a role in severe cases. Biopsychosocial therapies have shown encouraging results in initial trials but are beset by limited availability. Further research is necessary to understand the pathophysiology and provide specific focused therapies.

Clear cell colitis: A form of microscopic colitis in children

AIM: To describe a new clinical and pathological subtype of microscopic colitis in children. METHODS: A selected group of children with abdominal pain, constipation and/or diarrhoea showing discrete or no macroscopic abnormalities on endoscopy was described. RESULTS: Multiple biopsies of colon showed large mononuclear clear cells in lamina propria of mucous membrane provided that good quality histological sections were performed and observed under a higher magnification. Otherwise, they could be misinterpreted as artefacts. Their presence in routine histology might suggest a systemic storage disease (Whipple’s disease), and neuronal intestine dysplasia. Using immunohistochemical staining and electron microscopy we confirmed their origin from CD68 positive mononuclear macrophages. CONCLUSION: The presence of large clear cells is a constant microscopic feature. Failure of transient large bowel stationary macrophages plays a role in the pathogenesis of this benign microscopic clear cell colitis, sometimes coexisting with allergy.

Electrocardiograms changes in children with functional gastrointestinal disorders on low dose amitriptyline

AIM: To study the effects of low dose amitriptyline on cardiac conduction in children.

Gastrointestinal side effects in children with Wilson's disease treated with zinc sulphate

AIM:To investigate the side effects of a zinc sulphate therapy in a cohort of Polish pediatric patients with Wilson's disease. METHODS:We retrospectively analyzed a cohort of 53 pediatric patients with Wilson's disease treated at the Children's Memorial Health Institute in Warsaw, Poland between the years 1996 and 2011 with zinc sulphate. Patients were diagnosed with Wilson's disease according to the scoring system of Ferenci, with 49 cases confirmed by mutation analysis. Data about the dosage scheme of zinc sulphate, side effects and efficacy and toxicity of the treatment were collected and recorded in the patient's medical chart at each visit to the hospital. RESULTS:Mean age of diagnosis for the entire cohort was 10 years (range, 2.5-17 years). Duration of treatment with zinc sulfate was 83.3 wk (range, 8-344 wk). Side effects, all of gastrointestinal origin, were observed in 21 patients (40% 9 males and 12 females), irrespective of the duration of therapy. Thirteen out of 21 patients were over the age of 10 years. The most common ATP7B mutation was p.H1069Q. Esophagogastroduodenoscopy, performed in 7 patients (33.3%) suffering from persistent and severe abdominal pain, revealed gastrointestinal ulcerations or erosions with negative Helicobacter pylori tests in all subjects investigated. The above mentioned 7 patients were treated with proton pump inhibitors. Three of those experienced resolution of symptoms, whereas proton-pump inhibitors failed to alleviate symptoms of the remaining four children and conversion of therapy to D-penicillamine was needed. CONCLUSION:Zinc sulphate appears to cause significant gastrointestinal side effects, which children on therapy for Wilson's disease should be closely monitored for.

Non-responsive celiac disease in children on a gluten free diet

BACKGROUND Non-responsive celiac disease(NRCD) is defined as the persistence of symptoms in individuals with celiac disease(CeD) despite being on a gluten-free diet(GFD). There is scant literature about NRCD in the pediatric population.AIM To determine the incidence, clinical characteristics and underlying causes of NRCD in children.METHODS Retrospective cohort study performed at Boston Children’s Hospital(BCH). Children < 18 years diagnosed with CeD by positive serology and duodenal biopsies compatible with Marsh Ⅲ histology between 2008 and 2012 were identified in the BCH’s Celiac Disease Program database. Medical records were longitudinally reviewed from the time of diagnosis through September 2015. NRCD was defined as persistent symptoms at 6 mo after the initiation of a GFD and causes of NRCD as well as symptom evolution were detailed. The children without symptoms at 6 mo(responders) were compared with the NRCD group. Additionally, presenting signs and symptoms at the time of diagnosis of CeD among the responders and NRCD patients were collected and compared to identify any potential predictors for NRCD at 6 mo of GFD therapy.RESULTS Six hundred and sixteen children were included. Ninety-one(15%) met criteria for NRCD. Most were female(77%). Abdominal pain [odds ratio(OR) 1.8 95% confidence interval(CI) 1.1-2.9], constipation(OR 3.1 95%CI 1.9-4.9) and absence of abdominal distension(OR for abdominal distension 0.4 95%CI 0.1-0.98) at diagnosis were associated with NRCD. NRCD was attributed to a wide variety of diagnoses with gluten exposure(30%) and constipation(20%) being the most common causes. Other causes for NRCD included lactose intolerance(9%), gastroesophageal reflux(8%), functional abdominal pain(7%), irritable bowel syndrome(3%), depression/anxiety(3%), eosinophilic esophagitis(2%), food allergy(1%), eating disorder(1%), gastric ulcer with Helicobacter pylori(1%), lymphocytic colitis(1%), aerophagia(1%) and undetermined(13%). 64% of children with NRCD improved on follow-up.CONCLUSION NRCD after ≥ 6 mo GFD is frequent among children, especially females, and is associated with initial presenting symptoms of constipation and/or abdominal pain. Gluten exposure is the most frequent cause.

谓葆颗粒联合培菲康治疗小儿功能性腹痛临床疗效及对焦虑抑郁情绪的影响

目的探讨功能性腹痛患儿应用谓葆颗粒联合培菲康治疗的疗效及对患儿焦虑抑郁情绪影响。方法共计纳入102例功能性腹痛患儿(2019年3月—2023年9月入住湖北省妇幼保健院儿童消化内科),以随机数字表法分为观察组、对照组,每组51例。对照组患儿采取培菲康治疗,观察组患儿采取谓葆颗粒联合培菲康治疗。2组患儿治疗前后的结果,包括:疗效、腹痛及食欲不振、面色苍白等症状消失时间、儿童焦虑性情绪障碍筛查量表(SCARED)、儿童抑郁障碍自评量表(DSRSC)评分、不良反应。结果对照组与观察组患儿总有效率分别为84.31%、96.08%,观察组有效率高于对照组(P<0.05);观察组患儿腹痛及食欲不振、面色苍白等症状消失时间分别为(7.86±1.96)d、(4.95±0.38)d、(3.89±0.47)d,均短于对照组患儿[(10.45±1.15)d、(5.72±0.62)d、(5.10±0.38)d,P<0.05];治疗后观察组患儿SCARED及DSRSC评分分别为(10.15±1.52)分、(9.45±1.07)分,均低于对照组患儿[(17.49±2.95)分、(14.23±1.87)分,P<0.05];对照组与观察组患儿不良反应发生率分别为3.92%、1.96%,差异无统计学意义(P>0.05)。结论谓葆颗粒联合培菲康治疗小儿功能性腹痛临床疗效良好,患儿恢复快,还可较好改善患儿不良情绪,不良反应发生率较低,安全可靠。

功能性腹痛患儿的人格特点、生活质量及其相关性研究

目的分析功能性腹痛患儿与人格特点、生活质量、家庭教养方式之间的相关性,以期为临床护理干预提供理论依据。方法选取2022年8月—2023年9月福建省儿童医院收治的功能性腹痛患儿165例(观察组)与儿童保健科体检的健康儿童165例(对照组)进行研究。采用艾森克患儿人格问卷(Eysenck personality questionnaire,EPQ)、生活质量核心量表(pediatric quality of life inventorytm,PedsQLTM 4.0)、父母教养方式问卷(egna minnen av barndoms uppfostran,EMBU)、Wong-Baker面部表情疼痛量表评分,调查其功能性腹痛患儿与人格特点、生活质量和家庭教养方式的现状,探讨其影响因素。结果观察组腹痛评分为(13.95±2.16)分,高于对照组的(3.02±1.03)分(P<0.05)。观察组艾森克患儿人格问卷测试中P、N分值高于对照组,E分值低于对照组(P<0.05)。观察组生理功能、情感功能、社会功能、学校表现及总分值均低于对照组(P<0.05)。观察组F2、F3、M2高于对照组,F1、F4、M1、M5低于对照组(P<0.05)。功能性腹痛症状积分与父母教养方式F1、M1因子呈负相关,与F3、M2呈正相关;与艾森克患儿人格因子E呈负相关,与N、P因子呈正相关;与患儿生活质量呈负相关(P<0.05)。结论功能性腹痛患儿人格特点、生活质量和家庭教养方式三者之间存在相关性,情绪不稳定、性格内向及精神质人格的患儿是发生功能性腹痛的重要因素,而不良的家庭教养方式是本病发生的诱因,进一步加重病情,降低患儿生活质量。因此临床治疗上给予药物治疗外还应注重对患儿的心理干预,评估家庭教养方式以提高生活质量。

个性化护理干预在儿童功能性腹痛护理中的应用效果分析

目的:探讨个性化护理干预在儿童功能性腹痛护理中的应用效果。方法:选取2022年4-10月滨州医学院附属医院收治的80例功能性腹痛患儿作为研究对象,使用随机数字表法分为观察组、对照组,各40例。对照组进行常规护理,观察组进行个性化护理干预。比较两组护理效果。结果:观察组护理总有效率高于对照组,差异有统计学意义(P=0.048)。护理前,两组腹痛频率、腹痛程度评分比较,差异无统计学意义(P>0.05);护理后,两组腹痛频率、腹痛程度评分低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组患儿家属护理总满意度高于对照组,差异有统计学意义(P=0.040)。结论:个性化护理干预在儿童功能性腹痛护理中的应用效果显著,能够减少患儿腹痛发作次数,减轻腹痛程度,提高患儿家属护理满意度,值得临床应用。

家庭教养的干预模式对儿童功能性腹痛患者社会支持和应对方式的影响

目的探讨家庭教养的干预模式对儿童功能性腹痛患者社会支持和应对方式的影响。方法随机抽取在我院接受诊治的功能性腹痛患儿180例作为研究对象,时间选取自2022年7月至2023年6月,采取抽签法分为对照组和观察组,各90例。对照组予以常规干预模式,观察组予以家庭教养的干预模式。比较两组干预前后心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、生活质量、社会支持评定量表(SSRS)和应对方式情况。结果干预后三个月,两组SAS评分、SDS评分均降低且观察组更低(P<0.05);两组躯体功能躯体功能、心理活动、社会能力、物质生活状态干预后三个月的评分均升高且观察组更高(均P<0.05);干预后三个月后,观察组客观支持、主观支持、利用度各项评分均高于对照组(P<0.05)。对比应对方式,干预后三个月,观察组积极因子评分高于对照组,消极因子评分低于对照组(P<0.05)。结论家庭教养的干预模式对儿童功能性腹痛患儿社会支持和应对方式的影响具有积极的意义,有助于改善患儿心理状态,提升生活质量。

丁香茶辣散穴位贴敷联合小建中汤辨证治疗小儿脾胃虚寒型腹痛的效果分析

目的:分析丁香茶辣散穴位贴敷联合小建中汤辨证治疗小儿脾胃虚寒型腹痛的效果。方法:选取2021年1月—2023年1月南宁市武鸣区中医医院收治的60例脾胃虚寒型腹痛患儿作为研究对象,随机分为对照组与观察组,各30例。对照组实施小建中汤加减辨证治疗,观察组在对照组基础上应用丁香茶辣散穴位贴敷治疗。比较两组治疗效果。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.044)。治疗后,两组中医症状评分、脸谱疼痛评分法评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P=0.044)。结论:丁香茶辣散穴位贴敷联合小建中汤辨证治疗小儿脾胃虚寒型腹痛的效果较好,能够缓解疼痛及症状,且安全性好。

健脾温通方敷脐与百笑灸联合常规西药治疗小儿肠系膜淋巴结炎临床研究

目的:观察健脾温通方敷脐与百笑灸联合常规西药治疗肠系膜淋巴结炎寒积腹痛证患儿的临床疗效。方法:将94例肠系膜淋巴结炎寒积腹痛证患儿以随机数字表法分为参照组与治疗组各47例。参照组给予双歧杆菌乳杆菌三联活菌片和头孢克洛干混悬剂治疗,治疗组在双歧杆菌乳杆菌三联活菌片、头孢克洛干混悬剂治疗的基础上给予健脾温通方敷脐与百笑灸治疗。2组均治疗7 d。治疗前、治疗7 d后检测血清核因子-κB(NF-κB)、白细胞介素-10(IL-10)、绛钙素原(PCT)、可溶性髓系细胞触发受体-1(sTREM-1)、血浆内皮素-1(ET-1)、降钙素基因相关肽(CGRP)、乳酸(Lac)、二胺氧化酶(DAO)、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)水平,测定肠道肠杆菌、葡萄球菌、双歧杆菌、乳酸杆菌的菌群数量,统计肠系膜淋巴结的纵径、横径,观察患儿食欲不振、腹泻、腹痛、发热、恶心呕吐消失的时间,比较2组的临床疗效。结果:治疗后,治疗组总有效率高于参照组(P<0.05)。2组血清NF-κB、PCT、sTREM-1水平均较治疗前降低(P<0.05),血清IL-10水平均较治疗前升高(P<0.05)。治疗组血清NF-κB、PCT、sTREM-1水平均低于参照组(P<0.05),血清IL-10水平高于参照组(P<0.05)。2组血清IgG、IgA水平均较治疗前降低(P<0.05)。治疗组血清IgG、IgA水平均低于参照组(P<0.05)。2组血清CD4^(+)T淋巴细胞水平均较治疗前升高(P<0.05),血清CD8^(+)T淋巴细胞水平均较治疗前降低(P<0.05)。治疗组血清CD4^(+)T淋巴细胞水平高于参照组(P<0.05),血清CD8^(+)T淋巴细胞水平低于参照组(P<0.05)。2组血清DAO、ET-1、Lac水平均较治疗前降低(P<0.05),血清CGRP水平均较治疗前升高(P<0.05)。治疗组血清DAO、ET-1、Lac水平均低于参照组(P<0.05),血清CGRP水平高于参照组(P<0.05)。2组肠道肠杆菌、葡萄球菌菌群数量均较治疗前减少(P<0.05),双歧杆菌、乳酸杆菌菌群数量均较治疗前增多(P<0.05)。治疗组肠杆菌、葡萄球菌菌群数量均少于参照组(P<0.05),双歧杆菌、乳酸杆菌菌群数量均多于参照组(P<0.05)。2组肠系膜淋巴结纵径、横径均较治疗前缩短(P<0.05)。治疗组纵径、横径均短于参照组(P<0.05)。治疗组食欲不振、腹泻、腹痛、发热、恶心呕吐消失的时间均短于参照组(P<0.05)。结论:采用健脾温通方敷脐与百笑灸联合常规西药治疗肠系膜淋巴结炎寒积腹痛证患儿,可有效减轻炎症反应,改善患儿的肠黏膜屏障功能及肠道微生态,提升患儿的免疫功能,提高临床疗效。

中药穴位贴敷联合激光治疗在小儿肠系膜淋巴结炎腹痛中的临床效果

目的探讨中药穴位贴敷联合激光治疗在小儿肠系膜淋巴结炎腹痛中的临床效果。方法选取2020年7月至2022年7月广西医科大学附属武鸣医院儿科收治的88例肠系膜淋巴结炎患儿,采用随机数字表法分为对照组与观察组,每组各44例。两组均给予常规西药治疗,观察组加用中药穴位贴敷联合激光治疗。比较两组腹痛缓解时间、腹痛消失时间及腹痛复发率。结果观察组腹痛缓解时间及腹痛消失时间均短于对照组,差异有统计学意义(P<0.05)。观察组腹痛复发率低于对照组,差异有统计学意义(P<0.05)。结论中药穴位贴敷联合激光治疗在小儿肠系膜淋巴结炎腹痛中的临床效果确切,可有效改善腹痛症状,降低腹痛复发率,值得临床推广。

儿童Peutz-Jeghers综合征二例

目的分析儿童Peutz-Jeghers综合征的临床特点,探讨临床工作中Peutz-Jeghers综合征患儿急诊手术的注意事项和诊疗经验。方法回顾分析2例Peutz-Jeghers综合征患儿的临床资料。结果1例患儿以腹痛、呕吐起病,急诊行剖腹探查,行部分十二指肠切除术,术后腹痛复发,遂行肠套叠复位术,考虑Peutz-Jeghers综合征合并肠套叠;另1例患儿以腹痛、呕吐起病,急诊行剖腹探查,术后恢复良好,考虑Peutz-Jeghers综合征合并肠套叠。结论对于皮肤粘膜黑色斑点且出现外科急腹症的患儿,应考虑Peutz-Jeghers综合征,应首先解决患儿的急腹症,尽可能保留套叠的肠段,术中切除较为明显的息肉,不做预防性息肉切除,术后依据病理检查结果和基因检测结果,定期对患儿进行全胃肠道监测和息肉切除术,提高患儿远期生活质量。

Inverted Meckel's diverticulum: Two case reports and a review of the literature

Gastrointestinal surgeons seldom encounter inverted Meckel's diverticulum in their clinical practice. We describe two cases of inverted Meckel's diverticulum. If the patient has a disease-related complication such as intussusception, as with our first case, it can be easily detected. However, if the patient has subacute or chronic symptoms, as with our second case, the diagnosis might be delayed. Regardless of the diseaserelated complication, intussusception of inverted Meckel's diverticulum can be easily managed with laparoscopic single-port surgery.