ABSTRACT
Aims: Duodenal nodularity is an uncommon endoscopic appearance of numerous visible mucosal nodules in the proximal duodenum. In this retrospective study we aimed to determine the clinical significance and histopathologic features of duodenal nodularity in children. Materials and Methods: The medical records of the patients who were defined to have duodenal nodularity by endoscopy were reviewed. Statistical Analysis Used: The data were expressed as mean ± SD and percentages (%). Results: Seventeen patients with endoscopically defined duodenal nodularity were chosen. The mean age at diagnosis was 12.1 years (range: 6-17 years), 9 males. Abdominal pain (47%) was the most common clinical symptom and antral nodularity (41%) was the most common endoscopic finding in children with duodenal nodularity. Histopathologic evaluation of duodenal nodules revealed chronic inflammation in all patients, increased intercryptal and intraepithelial numbers of eosinophils in 70.5%, and villous atrophy in 47% of patients. Giardia infestation was demonstrated in 6 patients by histologic examination and/or Giardia lamblia-specific antigen positivity in stools. The clinical diagnoses of the patients have shown variations, such as celiac disease, giardiasis, secretory IgA deficiency, and Helicobacter pylori gastritis, and some of them were associated with the others. Conclusions: Although the endoscopic appearance is similar, clinical spectrum and pathologic features are not so similar and there are no specific histomorphologic findings for nodularity. The most demonstrative findings we observed in children were increased lymphocyte and/or eosinophil infiltration in the duodenal mucosa. We suggested that care should be taken in the evaluation of microbiological and immunologic etiologies causing this prominent inflammatory reaction.
Subject(s)
Adolescent , Child , Duodenum/pathology , Endoscopy, Gastrointestinal , Eosinophils/cytology , Female , Histocytochemistry , Humans , Intestinal Mucosa/pathology , Lymphocytes/cytology , Male , Retrospective StudiesABSTRACT
Nuestro objetivo es presentar los principales hallazgos en diagnóstico por imagen de las enfermedades del intestino delgado en una secuencia ordenada, ofreciendo una correlación patológico- radiológica de cada una de ellas. Estas anormalidades fueron clasificadas en entidades difusas y focales. La enfermedad difusa compromete todo el intestino delgado o, al menos, cinco asas intestinales. Las entidades focales son enfermedades localizadas. En primer lugar se considerará la enfermedad difusa, diferenciando tres patrones serán estudiadas las principales entidades que pueden provocarlas, enfatizando los hallazgos clave que permiten estrechar las opciones de diagnóstico diferencial.
Our objective is to present in an orderly way the main radiological findings of the small bowel diseases, offering a radiologic- pathologic correlation of each of them. We divide theseabnormalities in diffuse and focal entities. Diffuse disease involves the whole small bowel or at least five intestinal loops. Focal entities are localized diseases. First we are going to consider the topic of diffuse disease differentiating three patterns: thickening of folds, nodularityand dilatation. In each of these three patterns the main entities that cancause them are considered, emphasizing the key findings that allow the narrowing of the differential diagnosis.
Subject(s)
Intestine, Small/pathology , Diagnostic ImagingABSTRACT
Objective To investigate the association between the nodular gastritis and the eradication of Helicobacter pylori .Methods To the patients with nodular gastritis discovered by gastroendoscopy during 2001～2002, detection of Helicobacter pylori and eradication of it if positive, were performed then followed up after 6 months by endoscopies.Results From 4939 cases of endoscopy thirteen cases of female nodular gastritis were diagnosed, accounted to 0 26% of the total cases examined. The age of patients ranged from 14～49 years, with mean age 29 years.The main symptom is epigastralgia. All cases were found affected with H.pylori . After H.pylori eradication, there is disappearance of the nodular appearance of the gastric antrum under endoscopies and disappearance of the gastric submucosal lymphoid follicles under histological examination.Conclusion Nodular gastritis is the very important manifestation having a high positive predictive value in H.pylori infection.