The study encounted 20 patients of 2 months to 2 years old had diagnosis of necrotizing enteritis (N.E) admitted to the National Hospital of Pediatrics (NHP) between April 1991 to June 2003.These patients were analysed for clinical features and laboratory findings. The results showed that the main age group suffered from N.E is 2 to 12 months (18 patients, 90%). Male to female ratio is 2.33/1. Most of them live in the rural areas (85%). 80% of these children were not breastfeeded. The clinical features of N.E are rather abundant. Symptoms of intestinal obstruction: abdominal pain, vomiting, abdominal distention, blood feces and peritonitis. They has hypovolemic shock wish CVP<5cmH2O, dehydrations. Abdomen X rays has manifestations of intestinal obstruction, peritonitis. The abdominal fluids have yellow color (53%), blood fluids (40%), high protein (21+-10.6g/l), rivalta (+), cells of abdomal fluids: 177+-107 cells/mm3. Status of anemia and hypoproteinemia, blood solitary with Hct 43.3+-7.12%. Uncompensated metabolic acidosis with pH <7.16+-0.16, BE-15+-5.
Enteritis, Child, Diagnosis

Adolescent ; Child ; Child, Preschool ; Diagnostic Errors ; Enteritis ; diagnosis ; Eosinophilia ; diagnosis ; Female ; Gastritis ; diagnosis ; Humans ; Male ; Retrospective Studies

OBJECTIVETo explore the value of magnetic resonance enterography (MRE) for diagnosis of small intestinal diseases in children.

METHODA total of 92 children who received MRE from July 2009 to January 2014 were included into this study. The clinical value of MRE in children was evaluated by describing the image presentation of MRE based on clinical diagnosis.

RESULTAll the 92 cases (average age was nine year and one month, among whom 61 were boys, and 31 were girls) received MRE examination with good tolerance and had no complications. Eleven cases (12%) did not show good distension of small bowel loop during MRE and could not evaluate the bowel wall pathologies correctly. A total of 66 cases (72%) showed pathological MRE images. All patients with Crohn's disease showed pathological gut and 53% (16/30) showed extramural changes with MRE, 97% (29/30) showed colon lesions with colonoscopy, 73% (20/22) showed small intestine lesions with capsule endoscopy. All patients with intestinal obstruction (7 cases) showed abnormal gut distension, 4 of whom showed obstruction point. Five patients with small intestinal neoplasms showed the mass with MRE. One of the patients with intestinal tuberculosis showed enlarged lymph nodes with ring strengthening. Nine cases with eosinophilic gastroenteritis (75%) and 1 case of gastrointestinal bleeding showed increased contrast enhancement for small bowel. The main finding of MRE were abnormal wall thickening and enhancement, gut stricture, bowel expansion, etc.

CONCLUSIONMRE for children was safe and reliable. It can be a suitable method for determining the location and extent of gut for small intestinal diseases, especially suitable for Crohn's disease in children.

Capsule Endoscopy ; Child ; Colonoscopy ; Crohn Disease ; diagnosis ; Enteritis ; diagnosis ; Eosinophilia ; diagnosis ; Female ; Gastritis ; diagnosis ; Gastrointestinal Hemorrhage ; diagnosis ; Humans ; Intestinal Obstruction ; diagnosis ; Intestine, Small ; physiopathology ; Magnetic Resonance Imaging ; Male

OBJECTIVEStudy on the infection rate,influence factors and clinical characteristic of rotavirus diarrhea in children.

METHODS634 hospitalized diarrhea children was collected from 2006 June to 2010 October. The gold immunochromatographic double-antibody sandwiched assay was used to detect the antigen of Rotavirus directly. The age of onset, incidence, clinical features and multiple organ damage and other aspects were summarized and analyzed.

RESULTS308 cases was detected positively in the 634 specimens, the positive rate was 48.6%. In 6 to 12 months old children 197 cases was detected positively, accounted for 66.3%. Rotavirus was detected all the year round and the positive rate was higher in the first quarter and the forth quarter and was 63.8% and 62. 6% respectively. 68.6% accompanied with myocardial damage, 41.2% with lower respiratory tract infection, 13.3% with liver damage, 14.9% with renal damage, 9.4% with convulsions in 4.9%, accompanied by the damage of blood system.

CONCLUSIONRotavirus is the leading cause of pediatric diarrhea the main pathogens, 6-12 months infants with the highest infection rate, the first, the fourth quarter is higher. Rotavirus infection can cause multiple organ dysfunction.

Child, Preschool ; China ; Enteritis ; diagnosis ; epidemiology ; virology ; Female ; Humans ; Incidence ; Infant ; Male ; Rotavirus ; genetics ; isolation & purification ; Rotavirus Infections ; diagnosis ; epidemiology ; virology ; Seasons

Intestinal tuberculosis (TB) is presented with nonspecific and variable clinical manifestations such as abdominal pain, diarrhea, fever and weight loss. Diagnosis of tuberculous enteritis may be missed or confused with many other chronic gastrointestinal disorders such as the Crohn disease and intestinal neoplasms. The diagnosis should be based on careful clinical evaluations, such as extra-intestinal signs and colonoscopic and histologic findings. Newer techniques such as PCR tests from the specimens through colonoscopic biopsy may be helpful to confirm diagnosis of tuberculous enteritis. The treatment regimens for pulmonary tuberculosis are generally effective for tuberculous enteritis as well. If not treated early, the prognosis of intestinal tuberculosis is poor. We report a case of tuberculous enteritis diagnosed by colonoscopic biopsy and TB PCR which was presented with diarrhea, abdominal pain, intermittent fever and weight loss in a 12-year-old girl with active pulmonary tuberculosis. The patient was treated successfully with antituberculosis agents for 11 months without any complications.
Abdominal Pain ; Biopsy ; Child* ; Crohn Disease ; Diagnosis ; Diarrhea ; Enteritis* ; Female* ; Fever ; Humans ; Intestinal Neoplasms ; Polymerase Chain Reaction ; Prognosis ; Tuberculosis ; Tuberculosis, Pulmonary* ; Weight Loss

PURPOSE: To investigate the frequency, presentation, management, and outcome of cytomegalovirus (CMV) infection in pediatric patients who underwent renal transplantation. METHODS: We performed a retrospective chart review of 70 patients under the age of 18, who underwent renal transplantation between January 1990 and November 2014. A diagnosis of CMV infection was based on serology, molecular assays, antigenemia assays, and culture. CMV infection was defined as detection of virus and CMV disease was diagnosed when clinical signs and symptoms were present. RESULTS: The number of patients with CMV infection was 18 (25.7% of renal transplant recipients). Twelve were male (66.7%), and the mean±standard deviation (SD) age at infection was 13.3±3.9 years. Median time of infection after renal transplantation was 4 months (range 1.0-31.0 months). Pretransplantation CMV status in the infected group was as follows: donor (D)+/recipient (R)+, 11 (61.1%); D+/R-, 7 (38.9%); D-/R+, 0; and D-/R- 0. Nine patients had CMV disease with fever, leukopenia, thrombocytopenia, or organ involvement such as enteritis, hepatitis, and pneumonitis. The age of disease occurrence was 13.1±3.9 years and the median time to disease onset after renal transplantation was 8 months (range 1.0-31.0). Immunosuppressive agents were reduced or discontinued in 14 patients (77.8%), antiviral agents were used in 11 patients (61.1%), and all patients with CMV infection were controlled. CONCLUSIONS: A quarter of the patients had CMV infection about 4 months after renal transplantation. CMV infection was successfully treated with reduction of immunosuppressants or with antiviral agents.
Antiviral Agents ; Child ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Diagnosis ; Enteritis ; Fever ; Hepatitis ; Humans ; Immunosuppressive Agents ; Kidney Transplantation ; Leukopenia ; Male ; Pneumonia ; Retrospective Studies ; Thrombocytopenia ; Tissue Donors ; Transplant Recipients*

PURPOSE: To investigate the frequency, presentation, management, and outcome of cytomegalovirus (CMV) infection in pediatric patients who underwent renal transplantation. METHODS: We performed a retrospective chart review of 70 patients under the age of 18, who underwent renal transplantation between January 1990 and November 2014. A diagnosis of CMV infection was based on serology, molecular assays, antigenemia assays, and culture. CMV infection was defined as detection of virus and CMV disease was diagnosed when clinical signs and symptoms were present. RESULTS: The number of patients with CMV infection was 18 (25.7% of renal transplant recipients). Twelve were male (66.7%), and the mean±standard deviation (SD) age at infection was 13.3±3.9 years. Median time of infection after renal transplantation was 4 months (range 1.0-31.0 months). Pretransplantation CMV status in the infected group was as follows: donor (D)+/recipient (R)+, 11 (61.1%); D+/R-, 7 (38.9%); D-/R+, 0; and D-/R- 0. Nine patients had CMV disease with fever, leukopenia, thrombocytopenia, or organ involvement such as enteritis, hepatitis, and pneumonitis. The age of disease occurrence was 13.1±3.9 years and the median time to disease onset after renal transplantation was 8 months (range 1.0-31.0). Immunosuppressive agents were reduced or discontinued in 14 patients (77.8%), antiviral agents were used in 11 patients (61.1%), and all patients with CMV infection were controlled. CONCLUSIONS: A quarter of the patients had CMV infection about 4 months after renal transplantation. CMV infection was successfully treated with reduction of immunosuppressants or with antiviral agents.
Antiviral Agents ; Child ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Diagnosis ; Enteritis ; Fever ; Hepatitis ; Humans ; Immunosuppressive Agents ; Kidney Transplantation ; Leukopenia ; Male ; Pneumonia ; Retrospective Studies ; Thrombocytopenia ; Tissue Donors ; Transplant Recipients*

PURPOSE: To evaluate the usefulness of CT for the diagnosis of the cause and localization of small bowel obstruction. MATERIALS AND METHODS: Out of a group of children who underwent a CT examination for a suspected small bowel obstruction, 19 patients with confirmed underlying disorders were identified and included in the study. Neonates and patients with duodenal obstruction were excluded from the study. The CT findings were analyzed for the location of obstruction site, abnormalities of the mesentery and mesenteric vessels, bowel wall thickening, closed loop obstruction, and strangulation. The obstruction site was divided into five parts. The preoperative CT diagnosis was compared with the final diagnosis. RESULTS: Causes of small bowel obstruction were intussusception (n = 6), appendiceal perforation (n = 4), transmesenteric internal hernia (n = 2), postoperative bands (n = 1), idiopathic multiple bands (n = 1), a foreign body (n = 1), a small bowel adenocarcinoma (n = 1), Meckel's diverticulitis (n = 1), tuberculous peritonitis (n= 1) and Salmonella enteritis with bowel perforation (n = 1). The CT findings showed mesenteric vascular prominence (n = 13), omental or mesenteric infiltration (n = 10), localized bowel wall thickening (n = 7), closed loops obstruction (n = 3) and strangulation (n = 1). The obstruction site was identified in all cases. The causes of obstruction could be diagnosed preoperatively in 14 cases, but a preoperative diagnosis was difficult in 5 cases. CONCLUSION: The causes of small bowel obstruction in children are variable, and CT is useful for evaluating the cause and localization of small bowel obstruction.
Adenocarcinoma ; Child* ; Diagnosis* ; Diverticulitis ; Duodenal Obstruction ; Enteritis ; Foreign Bodies ; Hernia ; Humans ; Infant, Newborn ; Intestinal Obstruction ; Intestine, Small ; Intussusception ; Mesentery ; Peritonitis, Tuberculous ; Salmonella ; Tomography, X-Ray Computed

Ischemic enteritis is caused by embolism or thrombosis of superior mesenteric artery and nonocclusive ischemia. Mesenteric venous thrombosis, drugs, and vasculitis are less frequent etiologic factors. In children, occlusion of microcirculation by fibrin thrombi initiated by endotoxemia may be an etiology. Severe abdominal pain, vomiting, and diarrhea with evidence of gross or microscopic bleeding are common presenting symptoms. Angiography may be diagnositic and permit therapeutic intervention. Revascularization with resection of necrotic bowel is the treatment of choice. We experienced a case of ischemic enteritis that was presented with projectile vomiting and diarrhea. Diagnosis was confirmed histologically. Radiological findings suggested multiple adhesive ileus. Laparatomy was followed by resection of the necrotic bowel.
Abdominal Pain ; Adhesives ; Angiography ; Child ; Diagnosis ; Diarrhea ; Embolism ; Endotoxemia ; Enteritis* ; Fibrin ; Hemorrhage ; Humans ; Ileus ; Ischemia ; Mesenteric Artery, Superior ; Microcirculation ; Thrombosis ; Vasculitis ; Venous Thrombosis ; Vomiting

PURPOSE: Campylobacter species are common causes of bacterial enteritis. There is limited knowledge on its prevalence and clinical features because of its fastidious culture conditions. The purpose of this study was to identify the clinical features of Campylobacter enteritis in children. METHODS: We obtained stool specimens from patients diagnosed with acute gastroenteritis in the Department of Pediatrics, Nowon Eulji Medical Center (NEMC) and identified the pathogens by performing cultures or polymerase chain reactions (PCR). We retrospectively reviewed the medical records of patients with Campylobacter enteritis at NEMC between January 2012 and December 2017. RESULTS: Overall, 123 patients were diagnosed with Campylobacter enteritis (60 by culture and PCR in EnterNet and 110 by multiplex PCR). The median (interquartile range [IQR]) age of patients was 12 years (IQR, 8 to 16 years). The disease occurred all year round, but 69.9% from June to September. Symptoms included diarrhea (97.6%), fever (96.7%), abdominal pain (94.3%), vomiting (37.4%), and headache (34.1%). Compared with other treatments, treatment with azithromycin was associated with a shorter hospitalization period (P<0.05). CONCLUSIONS: Campylobacter enteritis is common during summer and mostly infects adolescent patients. It causes severe abdominal pain and fever preceding the onset of diarrhea. Prompt diagnosis and appropriate use of antibiotics reduces the duration of the disease.
Abdominal Pain ; Adolescent ; Anti-Bacterial Agents ; Azithromycin ; Campylobacter ; Child ; Diagnosis ; Diarrhea ; Enteritis ; Fever ; Gastroenteritis ; Headache ; Hospitalization ; Humans ; Medical Records ; Pediatrics ; Polymerase Chain Reaction ; Prevalence ; Retrospective Studies ; Vomiting