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Histopathological differences in pediatric duodenogastric reflux: a comparative study.
Sevde Nur Türker1, Zeren Barış2, Nazlı Sena Şeker3
1Faculty of Medicine, Department of Pediatrics, Eskişehir Osmangazi University, Eskişehir, Turkey.
European Journal of Pediatrics
|May 14, 2025
Summary
Pediatric duodenogastric reflux (DGR) diagnosis is improved by identifying key histopathological markers. Fibrosis, congestion, foveolar hyperplasia, and edema are significant indicators in children with DGR.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Pathology
- Bile Reflux
Background:
- Duodenogastric reflux (DGR) in children lacks standardized diagnostic methods.
- While some histopathological features like foveolar hyperplasia and fibrosis are known in adults, their role in pediatric DGR is less understood.
Purpose of the Study:
- To evaluate and compare gastric histopathological findings in pediatric patients with and without endoscopically confirmed DGR.
- To identify potential morphological changes associated with bile reflux in childhood.
Main Methods:
- Retrospective study comparing children with confirmed DGR to age- and sex-matched controls.
- Re-evaluation of gastric biopsy samples by a single pathologist blinded to clinical data.
- Comparison of histopathological features including inflammation, fibrosis, congestion, edema, and foveolar hyperplasia.
Main Results:
- Fibrosis, congestion, foveolar hyperplasia, and edema were significantly more prevalent in the DGR group compared to controls.
- Logistic regression identified foveolar hyperplasia (OR 10.67), edema (OR 9.01), fibrosis (OR 6.98), and congestion (OR 5.85) as independent predictors of DGR.
- These features were significantly more common in pediatric patients with DGR.
Conclusions:
- Fibrosis, congestion, foveolar hyperplasia, and edema are significantly associated with DGR in pediatric patients.
- These findings may serve as supportive histological markers for the diagnosis of DGR in children.
- Combining endoscopic findings with histopathology can aid in diagnosing DGR in children.
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