Endoscopic Removal of Foreign Bodies in Upper GI Tract in Children

PURPOSE: The foreing bodies in the upper GI tract are chiefly caused by accidental swallowing and rarely provoke symptoms. It is recommended to remove the foreign bodies if they produce symptoms or remain in GI tract for long duration or complications are expected to bring about. Nowadays the development of pediatric therapeutic endoscopy enables the removal of the foreign bodies in upper GI tract easily. METHODS: A clinical study of 30 cases of pediatric patients with the foreign bodies in the upper gastrointesinal tract diagnosed by the endoscopy at Seoul Red Cross hospital from January 1991 to December 1995 was perforemed. RESULTS: 1) The ages ranged from 1 year to 9 years and the male to female ratio was 2.3:1. 2) The types of ingested foreign bodies were coins (63.3%), audiokeys (10.0%), plastic toy (3.3%), earphone cap (3.3%), metal (3.3%), screw (3.3%), and battery (3.3%). Eighteen cases (60.0%) were located in the 1st narrowing part of the esophagus and 10 cases (33.3%) were in the stomach 3) Presenting symptoms were asymptomatic in 46.7%, dysphagia in 20.0%, vomiting in 16.7%, sore throat in 10.0%, and poor oral intake in 10.0%. The most common symptom in the cases of gastric foreign bodies was asymptomatic (90%), and common symptoms in the cases of 1st esophageal foreign bodies were dysphagia (33.3%), vomiting (27.8%) and asymptomatic (27.8%). 4) Abnormal endoscopic findings were erosive gastritis (16.7%), erosive esophagitis (6.7%), esophageal ulcer (3.3%), esophagitis (3.3%), and pharyngeal necrosis (3.3%) in order. CONCLUSIONS: The upper GI endoscope is a safe and essential method to diagnose and treat foreign bodies in the upper GI tract in pediatric patients.

Measles Hepatitis in Children

PURPOSE: Measles infection in children has been known to have many complications including hepatitis. But there has been no appropriate study about measles hepatitis in children. So we studied to facilitate the understanding of measles hepatitis in children by analyzing their clinical features and laboratory findings. METHODS: We investigated 164 patients who were admitted to the Department of Pediatrics, Seoul Red Cross Hospital due to measles from January 1985 to December 1994. We excluded other factors such as hepatitis A, B, C virus, Epstein-Barr virus and cytomegalovirus which could also result in hepatitis. According to the presence and the absence of coexistent complications 22 measles hepatitis patients were divided into two groups in which clinical characteristics and laboratory findings were analyzed as well. RESULTS: 1)Of total 164 patients there were 26 patients(15.9%) with measles hepatitis. 2)The ratio of male to female was 1.8:1. The range of age distribution was 6 months to thirteen years, and patients from 6 months to 3 years of age occupied 50% of the total patients. 3)The mean values of serum AST and ALT levels were 151+/-17.6 IU/L and 185+/-36.6 IU/L, espectively. And they were detected at 4.4+/-2.4 days after the first symptoms of measles were developed. 4)Major clinical characteristics were diarrhea in 22.7%, vomiting in 13.6%, hepatomegaly in 9.1%, and splenomegaly in 4.5%. Jaundice was not detected. 5)There was no difference between two groups in terms of serum albumin, globulin, bilirubin, AST and ALT(p>0.05). 6)Elevated serum AST and ALT levels returned to normal values within 2 weeks in 87.5%. CONCLUSIONS: Measles hepatitis develops with favorable outcome. Liver function test may well be done in cases of measles infection because hepatic dysfunction does not uncommonly occur in measles infection. Further study for the difference of the incidence of measles hepatitis according to the measles epidemics should be performed.

Prospective, Controlled Trial with Diphenyl dimethyl dicarboxylate in Children with Chronic Liver Diseases: The Effect on Lowering Serum Aminotransferase Levels

No abstract available.