ABSTRACT
Objective: To evaluate spectrum, efficacy and safety of Endoscopic retrogradecholangiopancreatography (ERCP) in pediatric population. Methods: Retrospective caserecord review of pediatric patients (age ≤15 y) undergoing ERCP between January 2011 toJune 2015 at a tertiary care referral hospital in New Delhi, India. The Indications for ERCP,cannulation success rate, procedure success rate and complications were recorded.Results: The mean (SD) age of the participants were 11.5 (3) years. 164 ERCP procedureswere done in 126 patients (67 males). All procedures were done under conscious sedation.The common indications for ERCP were choledocholithiasis (50, 30.5%), chronic calcificpancreatitis (38,23.2%), main pancreatic duct injury with leak (21,12.8%), and bile leak(12,7.3%). The cannulation success rate was 90.4% (114 out of 126), while proceduralsuccess rate was 86% (141 out of 164). Overall 8 complications were encountered; all weresuccessfully managed conservatively. Conclusions: ERCP in children can be successfullyperformed at centers with such expertise.
ABSTRACT
Objective: To evaluate the proportion of children with moderate to severe iron-deficiencyanemia who have associated celiac disease. Methods: This cross-sectional analytical studywas conducted among children aged 1 to 12 years of age with moderate-to-severe irondeficiency anemia and control children without anemia.Serum IgA-tissue trans-glutaminaselevels were assessed in both cases and controls. All children with positive celiac serologyunderwent upper gastrointestinal endoscopy and duodenal biopsy; biopsy finding of Marshgrade 3 was considered positive for celiac disease. Results: There were 152 anemic childrenand 152 controls with mean (SD) hemoglobinof 7.7 (1.8) and 12.2 (0.74) g/dL, respectively.16 (10.5%) cases and 3 (2%) control patients had positive serology for celiac disease [OR(95% CI) 5.33 (1.52-18.67), P=0.007]. Six (3.9%) children with iron-deficiency anemia andnone of the controls had biopsy features diagnostic of celiac disease. Conclusion:In theNorthern Indian tertiary-care hospital outpatient setting, Celiac disease was associated with4% of children presenting with moderate-to-severe anemia.