ABSTRACT
BACKGROUND: Esophageal stricture due to caustic ingestion is one of the most difficult problems to manage. Esophageal dilations are the usual treatment and they require a great number of sessions in the majority of cases. This implies time, risks for the patient, anguish for the relatives, and very often, frustration for the physician. OBJECTIVES: To evaluate the efficacy of the application of topical mitomycin C and intralesional triamcinolone in the prevention of post-dilation esophageal stricture recurrence. MATERIAL AND METHODS: A prospective, comparative, nonrandomized, and longitudinal study was conducted that compared a cohort of 16 patients treated with mitomycin C (2009-2012) with a retrospective cohort of 34 patients treated with triamcinolone (2002-2009). RESULTS: The patients treated with intralesional triamcinolone had a median of 11 dilations (minimum 4 and maximum 24), whereas the median in the patients treated with topical mitomycin C was 4.5 (minimum 3 and maximum 8). The groups were compared using the Mann-Whitney U test, finding a statistically significant difference of a two-tailed P<.001. In the multiple linear regression model, the dependent variable was the number of dilations and the independent variables were the type of lesion and treatment. The result was an R(2) .676 with a significance level of P<.001, in which the regression coefficient for treatment was B -.682 (95% CI -8.286 to -5.025) and the lesion grade was B .435 (95% CI 2.043- 4.573). The ANOVA result was an F 49.08 and a P<.001 and showed that the independent variables of type of lesion and treatment had a linear relation with the number of dilations, reinforcing the fact that our results were not due to chance. CONCLUSIONS: Topical mitomycin C considerably reduced the number of esophageal dilations compared with the use of intralesional triamcinolone to alleviate dysphagia, and therefore we suggest it as a treatment option in strictures due to caustic ingestion.
Subject(s)
Anti-Inflammatory Agents/administration & dosage , Antibiotics, Antineoplastic/administration & dosage , Burns, Chemical/complications , Esophageal Stenosis/drug therapy , Mitomycin/administration & dosage , Triamcinolone/administration & dosage , Administration, Topical , Anti-Inflammatory Agents/therapeutic use , Antibiotics, Antineoplastic/therapeutic use , Caustics/toxicity , Child , Child, Preschool , Combined Modality Therapy , Dilatation , Esophageal Stenosis/chemically induced , Esophageal Stenosis/therapy , Esophagoscopy , Female , Humans , Infant , Injections, Intralesional , Longitudinal Studies , Male , Mitomycin/therapeutic use , Prospective Studies , Recurrence , Retrospective Studies , Treatment Outcome , Triamcinolone/therapeutic useABSTRACT
We performed a rectal motility study in 39 children with encopresis and in 41 with chronic functional constipation. A three balloon system Schuster technic, was employed. Pressure changes were recorded. The "Inflation" reflex was absent in 23/39 children with Encopresis 59% and in 11/41. 26.8% with chronic functional constipation (p < 0.05).
Subject(s)
Constipation/physiopathology , Encopresis/physiopathology , Age Factors , Anal Canal/physiopathology , Child , Child, Preschool , Chronic Disease , Female , Gastrointestinal Motility/physiology , Humans , Male , Manometry/methods , Pressure , Rectum/physiopathology , Reflex/physiology , Transducers, PressureABSTRACT
Se estudiaron 80 niños, 41 con constipación funcional crónica y 39 con encopresis que acudieron al servicio de Gastroenterología del Instituto Nacional de Pediatría (INP) durante el período comprendido de enero de 1993 a enero de 1994. A todos ellos se les efectuó estudio de motilidad anorectal mediante la técnica de Schuster de triple balón. La presión basal de reposo del esfincter interno en los niños constipados fue de 47.15 mm Hg. mientras que en los encopréticos fue de 59.56 mm Hg (P<0.0008). El reflejo recto anal inhibitorio estuvo presente en los 80 pacientes (p>0.05). En cuanto al reflejo de inflación o contracción éste se encontró ausente en 23/39 niños con encopresis (59 por ciento), mientras que estuvo ausente en 11/44 niños constipados (26.8 por ciento) (p<0.05).
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Constipation/physiopathology , Encopresis/physiopathology , Age Factors , Anal Canal/physiopathology , Chronic Disease , Gastrointestinal Motility/physiology , Manometry , Pressure , Rectum/physiopathology , Reflex/physiology , Transducers, PressureABSTRACT
Se estudiaron 80 niños, 41 con constipación funcional crónica y 39 con encopresis que acudieron al servicio de Gastroenterología del Instituto Nacional de Pediatría (INP) durante el período comprendido de enero de 1993 a enero de 1994. A todos ellos se les efectuó estudio de motilidad anorectal mediante la técnica de Schuster de triple balón. La presión basal de reposo del esfincter interno en los niños constipados fue de 47.15 mm Hg. mientras que en los encopréticos fue de 59.56 mm Hg (P<0.0008). El reflejo recto anal inhibitorio estuvo presente en los 80 pacientes (p>0.05). En cuanto al reflejo de inflación o contracción éste se encontró ausente en 23/39 niños con encopresis (59 por ciento), mientras que estuvo ausente en 11/44 niños constipados (26.8 por ciento) (p<0.05). (AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Constipation/physiopathology , Encopresis/physiopathology , Anal Canal/physiopathology , Rectum/physiopathology , Manometry/methods , Transducers, Pressure , Pressure , Reflex/physiology , Gastrointestinal Motility/physiology , Age Factors , Chronic DiseaseABSTRACT
We performed a rectal motility study in 39 children with encopresis and in 41 with chronic functional constipation. A three balloon system Schuster technic, was employed. Pressure changes were recorded. The [quot ]Inflation[quot ] reflex was absent in 23/39 children with Encopresis 59
and in 11/41. 26.8
with chronic functional constipation (p < 0.05).
ABSTRACT
We studied 40 children with recurrent abdominal pain during a period of six months (january to june 1993) entered at the gastroenterology service of the Instituto Nacional de Pediatria in México City. In all of then we performed in all of them an upper gastrointestinal endoscopy with 3 biopsies from gastric mucosa (antrum) for histological examination and urease tests. We also did an ELISA test looking for an H. Pylori specific serum IgG response. Our control group were 40 healthy children in whom we did only the ELISA test. We did not find any statistics differences between the histologic findings (gold standard) and the urease and ELISA tests. With IgG antibodies prevalence for H. Pylori in children with recurrent abdominal pain were 57% in contrast with our control group in whom the prevalence was 5%.
Subject(s)
Abdominal Pain/microbiology , Helicobacter Infections/diagnosis , Helicobacter pylori , Adolescent , Biopsy , Child , Child, Preschool , Endoscopy , Female , Humans , Male , Prospective Studies , Recurrence , Urease/analysisABSTRACT
We studied 40 children with recurrent abdominal pain during a period of six months (january to june 1993) entered at the gastroenterology service of the Instituto Nacional de Pediatria in México City. In all of then we performed in all of them an upper gastrointestinal endoscopy with 3 biopsies from gastric mucosa (antrum) for histological examination and urease tests. We also did an ELISA test looking for an H. Pylori specific serum IgG response. Our control group were 40 healthy children in whom we did only the ELISA test. We did not find any statistics differences between the histologic findings (gold standard) and the urease and ELISA tests. With IgG antibodies prevalence for H. Pylori in children with recurrent abdominal pain were 57
in contrast with our control group in whom the prevalence was 5
.
