The value of endoscopy for chronic diarrhea in infants
10.3760/cma.j.issn.1007-5232.2015.03.009
- VernacularTitle:内镜检查在婴儿慢性腹泻诊断中的应用价值
- Author:
Zhaohui XU
;
Min YANG
;
Lanlan GENG
;
Sitang GONG
- Publication Type:Journal Article
- Keywords:
Endoscopy;
Diarrhea,Infantile;
Colitis,Lymphocytic;
Colitis,Ulcerative;
Crohn disease
- From:
Chinese Journal of Digestive Endoscopy
2015;(3):167-170
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical value of endoscopy for chronic diarrhea in infants and safety of gastroscopy replacing colonoscopy.Methods According to the Nelson chronic diarrhea definition,data of 52 hospitalized infants under 1 year from March 2006 to April 2014,who underwent colonoscopy because of diarrhea lasting for more than 2 weeks and achieving no improvement after series of treatments,or diarrhea suspected with severe milk protein allergy were collected.Endoscopy and mucosal biopsy were performed under intravenous anesthesia.Results A total of 49 cases (94.2%)were found abnormal under endoscopy.Lymphocytes,plasma cells and a little eosinophils were found in lamina propria in 26 cases,20-100 eosinophils/HPF were found in lamina propria in 21 patients,who were diagnosed as eosinophilic colitis.The 21 patients came back for open food challenge test 4 weeks later,16 cases were positive,who were diagnosed as milk protein allergy.Two infants with Crohn disease and ulcerative colitis respectively were treated with mesalazine and prednisone,but symptoms repeated.No complication was observed during endoscopy.Conclusion The etiology of infant chronic diarrhea is complex,except for peptic infections and lactose intolerance ,eosinophilic colitis may be the major cause.Ulcerative colitis and Crohn disease are rare in infants,but cannot be ignored .Endoscopy and mucosal biopsy are important in di-agnosis and treatment.Gastroscopy instead of colonoscopy is safe and effective.
