ABSTRACT
Peutz-Jeghers syndrome (PJS) presents in early childhood, and children have a higher risk of intussusception due to a smaller abdominal space than adults. Double-balloon enteroscopy (DBE) has been proven to be a safe and effective method for the diagnosis and treatment of small bowel lesions, but the efficacy and safety of its prophylactic polypectomy in children with PJS need to be determined. Data of 6 children (median age 10.6 years) diagnosed as having PJS from 2018 to 2020 were reviewed. DBE was performed 14 times, and 3 children were successfully relieved of intussusception after DBE treatment. The sizes of the resected intussusception polyps were 50 mm×60 mm, 40 mm×35 mm, and 50 mm×40 mm. Symptoms associated with polyps (abdominal pain, intussusception and obstruction) relieved after DBE in all children. No direct complications such as bleeding or perforation were found during the operation, and no recurrence of intussusception was found during follow-up. It can be seen that DBE polypectomy is safe and effective in the treatment of intussusception caused by PJS.
ABSTRACT
Objective@#To evaluate the efficacy and safety of compound Lactobacillus acidophilus tablets or Saccharomyces boulardii Sachets combined with standard protocols for eradication of Helicobacter pylori(Hp) in children.@*Methods@#From March 2017 to March 2018, 120 children aged 3-10 years with Hp infection were admitted into the Department of Gastroenterology, Maternal and Child Health Hospital of Hubei Province, including 67 male and 53 female childen.They were divided into 3 groups (control group, compound Lactobacillus acidophilus group, Saccharomyces boulardii Sachets group) by the method of random number table.Control group was given Clarithromycin+ Amoxicillin+ Omeprazole, for 14 days orally; compound Lactobacillus acidophilus group and Saccharomyces boulardii Sachets group were given drugs respectively on the first day, 500 mg of compound Lactobacillus acidophilus was added, twice a day or 250 mg of Saccharomyces boulardii Sachets group, twice a day orally, for 14 days, respectively.The adverse reactions in children were observed during the treatment, andurea 13C breath test or the stool Hp antigen test was performed at least 4 weeks by the end of the treatment, and the children with negative results were judged to be eradicated successfully.The ulcer healing, Hp eradication rate and incidence of adverse reactions(nausesa, vomiting, loss of appetite, constipation, diarrhea) among the 3 groups were observed and the Hp eradication rate and the incidence of adverse reactions (nausea, vomiting, loss of appetite, constipation, diarrhea) were compared.@*Results@#The eradication rates in the control group, the compound Lactobacillus group, and Saccharomyces boulardii Sachets group were 80.0% (32/40 cases), 85.0% (34/40 cases), and 87.5% (35/40 cases), respectively, and the difference was not statistically significant (P=0.646); the ulcer healing rate was 100.0% of 101 Hp eradicators in 3 groups, and the ulcer healing rate of 19 cases without Hp eradicated was 48.15%, and there was a significant difference between them (χ2=51.30, P<0.01). However, there was no significant difference in the total effective rate among 3 groups (P>0.05). The overall incidence of adverse reactions in Saccharomyces boulardii Sachets group (P=0.021) and the incidence of diarrhea (P=0.002) and loss of appetite (P=0.021) was lower than that in the control group, and the differences were statistically significant.There was no significant difference in the incidence of adverse reactions between the two probiotic groups (P>0.05).@*Conclusions@#Both compound Lactobacillus acidophilus tablets and Saccharomyces boulardii Sachets group can reduce the overall incidence of adverse reactions and the incidence of diarrhea and appetite declines in children′s standard Hp eradication regimen without affecting Hp eradication rate.