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[Chronic gastritis in children (author's transl)]
Insights
Chronic gastritis is common in children with abdominal pain, affecting gastric acid secretion. Endoscopic findings correlate with histological lesions, highlighting its significance in pediatric gastrointestinal pathology.
Area of Science:
- Pediatric Gastroenterology
- Histopathology
- Endoscopy
Background:
- Gastric mucosa biopsies were analyzed in 113 children (6 months-14 years).
- Patients were grouped by abdominal pain (Group A) or extragastric pathology (Group B, controls).
Purpose of the Study:
- To histopathologically evaluate gastric mucosa in children.
- To correlate endoscopic findings with chronic gastritis.
- To assess acid secretion in relation to gastritis severity.
Main Methods:
- Multiple endoscopic biopsies were taken from 113 children.
- Histopathological analysis followed Whitehead's criteria.
- Acid secretion studies (basal, maximal) were performed using pentagastrin stimulation.
Main Results:
- Chronic gastritis lesions were found in 48 of 97 children with abdominal pain.
- Specific endoscopic features correlated with histological gastritis in the gastric body and antrum.
- Advanced gastritis in the gastric body was associated with significantly lowered basal and maximal acid output.
Conclusions:
- Chronic gastritis is a significant finding in pediatric gastrointestinal pathology.
- Endoscopic visualization can predict histological gastritis.
- Gastritis severity impacts gastric acid secretion in children.
Abstract:
The gastric mucosa in 113 children from 6 months to 14 years old was studied from a histopathological point of view. Samples were obtained by means of a multiple biopsy technique during an endoscopic examination. The patients were divided into two groups. Group A was composed of 97 children with abdominal pain of an unknown etiology. Group B was formed of 16 patients with extragastric pathology in whom it was possible to take biopsies during an endoscopic exam. All of the biopsies were normal, and therefore were used as the control group. 49 patients from group A were histologically normal. In the other 48, lesions of chronic gastritis ranging in severity, were found in the antrum and/or in the gastric body. An analysis of the histopathological findings, and of the lesional sings of activity was done in accordance with Whitehead's criteria. Macroscopic objective features observed during the endoscopical examinations, were also evaluated and compared with the existence or nonexistence of chronic gastritis lesions. In the gastric body, the existence of endoscopic features such as enlarged folds, erosions or friable mucosa, were found to be coincident with the presence of histologic lesions of chronic gastritis. The same relationship was found in the antrum between the granular mucosa and/or irregular coloration and the lesions of chronic gastritis. In the same time, acid secretion studies (BAO, MAO and PAO) from 40 patients from group A were done using pentagastrin as a stimulant. It was demonstrated that both basal acid output and maximal acid were significantly lowered in cases of advanced lesions of chronic gastritis located in the gastric body. Finally the importance of this entity is emphasized in the gastrointestinal pathology in children.