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The radiologic and endoscopic investigation and etiologic classification of gastritis in children
D E Manson1, D A Stringer, P R Durie
1Department of Radiology, Hospital for Sick Children, Toronto, Ontario.
Insights
This study correlated endoscopic gastritis findings in children with imaging and pathology results. Endoscopic evaluation showed strong correlation with biopsy results, aiding in diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Pathology
Background:
- Gastritis in children can present with varied endoscopic appearances.
- Accurate diagnosis relies on correlating endoscopic findings with other diagnostic modalities.
- Establishing an etiological classification is crucial for appropriate management.
Purpose of the Study:
- To correlate endoscopic criteria for gastritis with radiologic and pathological findings in pediatric patients.
- To propose an etiological classification for gastritis in children based on diagnostic findings.
- To evaluate the diagnostic accuracy of different imaging techniques in conjunction with endoscopy.
Main Methods:
- Endoscopic examination of the gastric mucosa in 11 children.
- Correlation of endoscopic findings with histopathological analysis of biopsies.
- Comparison with radiologic findings from double-contrast and single-contrast barium studies.
- Classification of gastritis based on identified etiologies.
Main Results:
- Endoscopic findings correlated well with biopsy results in 10 out of 11 children.
- Double-contrast barium studies showed good correlation with endoscopic and histologic findings (8/9 cases).
- Single-contrast barium studies had limited correlation (1/3 cases).
- Diagnoses included Crohn's disease, eosinophilic gastroenteritis, diffuse varioliform gastritis, and Campylobacter pylori-associated gastritis.
Conclusions:
- Endoscopic assessment, supported by biopsy, is highly reliable for diagnosing gastritis in children.
- Double-contrast barium studies are valuable adjuncts for evaluating pediatric gastritis.
- An etiological classification aids in understanding and managing diverse causes of gastritis in this age group.
Abstract:
In 11 children the endoscopic criteria for gastritis were correlated with radiologic and pathological findings. An etiologic classification is proposed. The diagnoses included gastric involvement by Crohn's disease (five children), eosinophilic gastroenteritis (one), diffuse varioliform gastritis (two), erosive gastritis associated with Campylobacter pylori infection (two) and idiopathic erosive gastritis (one). Eight of the nine double-contrast barium studies and only one of the three single-contrast examinations correlated with the endoscopic and histologic findings. In 10 children the endoscopic results correlated well with the biopsy findings.