PURPOSE: Rotavirus is a leading cause of severe gastroenteritis in infants and young children around the world. The aim of this study is to investigate the fat content in stools of patients with rotaviral enteritis compared to the stools of children who had no gastroenteritis. METHODS: Seventy two patients who were admitted to Konkuk University Hospital, College of Medicine from Jun 2001 to May 2002 due to rotaviral enteritis and seventy five patients who were admitted at the same time with other diseases with no gastrointestinal problems as control, were enrolled in this study. The age of patients was from one month to five years. The average age of children with rotaviral enteritis was 17+/-11 months and the average age of control patients was 14+/-15 months. Fat content of stools was investigated by acid steatocrit tests in both patients with rotaviral enteritis and control. RESULTS: Acid steatocrit value of patients with rotaviral enteritis was higher than that of control patients. There was no difference in acid steatocrit value of children with rotaviral enteritis among the age groups. In one month- to six month-old infants, there was no difference in acid steatocrit values between the children with rotaviral enteritis and control patients. But, over the age of seven months, the acid steatocrit value of children with rotaviral enteritis was higher than that of control patients. CONCLUSIONS: We are of the opinion that fat malabsorption in patients with rotaviral enteritis and steatorrhea in rotaviral enteritis may result from decreased fat absorption in the small intestine.
Absorption ; Child* ; Enteritis* ; Gastroenteritis ; Humans ; Infant ; Intestine, Small ; Rotavirus ; Steatorrhea

Adult ; Diagnosis, Differential ; Female ; Humans ; Pancreas ; abnormalities ; Steatorrhea ; etiology

The digestive enzyme preparations are one of the most widely used drugs in Korea. However, it is rather misused or abused. Pancreatic enzyme supplement is only indicated for pancreatic insufficiency, such as cystic fibrosis, chronic pancreatitis, pancreatectomized patients. Pancreatic insufficiency causes malabsorption, most commonly manifested by steatorrhea. However, malabsorption symptoms are not apparent until the pancreas secretes less than 5% of its maximal secretory capacity, Which means that the use of enzyme preparations are very limited and should be prescribed after careful functional study of the pancreas. In Korea, however, digestive enzyme preparations are OTC drugs and furthermore, laymen's organizations insist that the digestive enzymes be sold freely in supermarkets. The concept about the use of digestive enzymes should be changed, and their proper use by physicians as well as laymen must be emphasized.
Cystic Fibrosis ; Exocrine Pancreatic Insufficiency ; Humans ; Korea ; Nonprescription Drugs ; Pancreas ; Pancreatitis, Chronic ; Steatorrhea

PURPOSE: Steatorrhea tests have been developed using various methods. Acid steatocrit is a simple method to detect steatorrhea and has very high sensitivity and specificity. This present study was designed to establish the normal values of acid steatocrit in Korean infants and to find the difference according to the various feeding methods. METHODS: Acid steatocrit tests were conducted on 128 infants who were under 12 months of age and who had non-specific gastrointestinal diseases between May 1998 and April 2001. The results were classified into neonatal ages(79 neonates), 1-6 months(28 infants), 7-12 months(21 infants). This included formula-fed(46 neonates) and human milk-fed(33 neonates), 1-6 months formula-fed (18 infants) and human milk-fed(10 infants), 7-12 months formula-fed(11 infants) and human milk-fed(10 infants). RESULTS: The acid steatocrit values decreased by infant age in months. Acid steatocrit values decreased much more after 7 months of ages. The acid steatocrit values of human milk-fed infants were significantly lower than those of formula-fed infants. CONCLUSION: Our study confirms that a physiologic steatorrhea was found in the infant period and decreases by infant age of months. The acid steatocrit test might be useful for the evaluation of gastrointestinal milk fat malabsorption disorders and therapeutic effects.
Feeding Methods ; Gastrointestinal Diseases ; Humans ; Infant* ; Milk ; Reference Values ; Sensitivity and Specificity ; Steatorrhea

Pancreaticoduodenectomy is the treatment of choice for adult periampullary lesions. However there has been no studies on the clinical outcomes of pancreaticoduodenectomy in children. To evaluate the clinical outcomes, records of 13 patients who underwent pancreaticoduodenectomy, from 1989 to 2009, at Seoul National University Children's Hospital were reviewed. Mean follow up period was 83 (2-204) months, the male to female ratio was 1:3.3, and the mean age was 11 (2-14) years. Ten patients underwent PPPD and 3 patients had Whipple's operation. The postoperative diagnosis included solid pseudopapillary tumor (9), cavernous hemangioma (1), pseudocyst (1), benign cyst (1), pancreatic disruption (1). Two patients developed postoperative adhesive ileus and among them one patient required operative intervention. Four patients required pancreatin supplementation due to steatorrhea and other gastrointestinal symptoms. There were no postoperative mortality during the follow up period and no evidence of recurrence in SPT patients. This study demonstrates that the pancreaticoduodenectomy procedure in children is not only feasible but also safe, with no mortality and an acceptable complication rate.
Adhesives ; Adult ; Child ; Female ; Follow-Up Studies ; Hemangioma, Cavernous ; Humans ; Ileus ; Male ; Pancreaticoduodenectomy ; Pancreatin ; Recurrence ; Steatorrhea

PURPOSE: The fecal acid steatocrit is an improved steatocrit method for the evaluation of fecal fat. The present study was set up in order to define the normal range of acid steatocrit values during the first 3 months of life. METHODS: Fecal acid steatocrit values were determined in 78 healthy full term and in 21 healthy prematurely born infants between May 1998 and April 2000. The acid steatocrit method was performed in these babies during the first 3 months of life. RESULTS: Steatorrhea occurs during the first month and then decreases, as shown by the fall in the acid steatocrit curve from 1st to 3rd month in our subject. Very high acid steatocrit results (above 90%) were found in all full term and premature infants during the first month of age. Acid steatocrit results of human milk-fed infants were significantly lower than those of formula-fed infants (p=0.0018). CONCLUSION: We conclude that high acid steatocrit results during the first 1 month of age can be due to physiologic steatorrhea. The acid steatocrit micromethod can be used for the evaluation of milk fat absorption in infants and monitoring steatorrhea instead of other more cumbersome methods.
Absorption ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Milk ; Reference Values ; Steatorrhea

Chylomicron retention disease, also known as Anderson's disease, is a rare hereditary hypocholesterolemic disorder, recessive inherited, characterized by nonspecific symptoms as abdominal distension, steatorrhea, and vomiting associated with failure to thrive. We describe a patient with failure to thrive, chronic diarrhea and steatorrhea who the diagnosis of chylomicron retention disease was established after several months of disease progression. The genetic study confirmed a homozygosity mutation in SAR1B gene, identifying a mutation never previous described [c.83_84delTG(p.Leu28Argfs*7)]. With this case report the authors aim to highlight for this very rare cause of failure to thrive and for the importance of an attempting diagnosis, in order to start adequate management with low fat diet supplemented with fat-soluble vitamins, reverting the state of malnutrition and avoiding possible irreversible and desvantating complications.
Diagnosis ; Diarrhea ; Diet ; Disease Progression ; Failure to Thrive ; Humans ; Malnutrition ; Rare Diseases* ; Steatorrhea ; Vitamins ; Vomiting

BACKGROUND: The pacreaticoduodenectomy is the procedure of choice for neoplasm of periampullary region. However, some complications such as glucose intolerance and maldigestion are developed on postoperative long-term follow-up. The aim of this study is to evaluate the volume change of remnant pancreas and difference of thickness change between PPPD and Whipples'operation. Material and METHODS: From November, 1988 to June, 1998, 110 patients with periampullary neoplasms had undergone pancreaticoduodenectomy in our hospital(Whipple procedure 67, pylorus-preserving pancreaticoduodenectomy 43). We selected 19 patients who had regular interval follow-up during at least 1 year and didn't have operation related complications and recurrence(Whipple procedure 8, PPPD 11). We examined the size of body and tail of pancreas on preoperative CT and postoperative CT. Medical records were reviewed to find body weight changes, occurrence of glucose intolerance and steatorrhea. RESULTS: The size of body and tail of pancreas were 16.2+/-3.9mm and 12.1+/-5.0mm preoperatively, 10.8+/-3.9mm and 8.3+/-3.5mm postoperatively(p<0.001). However, there was no significant difference between Whipple and PPPD group. The body weight reduced to 95% of preoperative body weight, but it didn't show statistic sigificance. The occurrence of glucose intolerance and steatorrhea were insignificant. CONCLUSION: We conclude that pancreatic atrophy develop in patients underwent pancreticoduodenectomy. But, the difference of thickness change between PPPD and Whipples'group is no significance. We suggest that further study is need to find out the cause of pancreatic atrophy and correlation between atrophy and resection method such as duodenum preserving pancreatic head resection versus pancreaticoduodenectomy. Also we recommend that long-term follow-up study is necessary to find out correlation between pancreatic atrophy and pancreatic endocrine, exocrine insufficiency.
Atrophy ; Body Weight ; Body Weight Changes ; Duodenum ; Follow-Up Studies ; Glucose Intolerance ; Head ; Humans ; Medical Records ; Pancreas* ; Pancreaticoduodenectomy* ; Steatorrhea

Progressive familial intrahepatic cholestasis (PFIC) is a group of severe genetic disorders, inherited in an autosomal recessive manner, causing cholestasis of hepatocellular origin, later progressing to biliary cirrhosis and liver failure. This is the first report of PFIC type 1 with novel compound heterozygous mutations in Korea. The patient was presented with intrahepatic cholestasis, a normal level of serum γ-glutamyl transferase, steatorrhea, and growth failure. Genetic testing of this patient revealed novel compound heterozygous mutations (p.Glu585Ter and p.Leu749Pro) in the ATP8B1 gene. After a liver transplantation at age 19 months, the patient developed severe post-transplant steatohepatitis.
Child ; Cholestasis ; Cholestasis, Intrahepatic ; Fatty Liver ; Genetic Testing ; Humans ; Korea ; Liver Cirrhosis, Biliary ; Liver Failure ; Liver Transplantation ; Steatorrhea ; Transferases

Chronic pancreatitis is a debilitating disease characterized by abdominal pain, exocrine insufficiency, and diabetes mellitus and has had great social, economic, and psychological impacts. Traditional definition of chronic pancreatitis has been based on irreversible histological findings such as self-sustaining chronic inflammation, fibrosis, and eventual destruction of ductal, exocrine, and endocrine tissues. In contrast, the traditional characteristics of acute pancreatitis have been thought as a complete recovery of pancreatic function and morphology during the convalescence period. Acute and chronic pancreatitis have been considered separated disease entities. However, the current idea regarding the natural course of pancreatitis is that acute pancreatitis can progress to the intermediate step of recurrent acute pancreatitis, and finally to chronic pancreatitis. This evolution can be characterized by a sequence of necrotic and fibrotic events, or described by sentinel acute pancreatitis event (SAPE) hypothesis. Therefore, chronic pancreatitis is better defined as a progressive inflammatory and fibrotic disease of the pancreas with clinical features of abdominal pain, malnutrition, diabetes mellitus and imaging features of pancreatic parenchymal/ductal calcifications. The complications of chronic pancreatitis include pseudocyst, pseudoaneurysm, fistula, biliary stricture, and duodenal stricture. This review describes the progression from acute to chronic pancreatitis, the mechanisms and nature of abdominal pain, steatorrhea, pancreatogenic diabetes mellitus, pseudocyst, pseudoaneurysm, and biliary stricture associated with chronic pancreatitis.
Abdominal Pain ; Aneurysm, False ; Biliary Fistula ; Constriction, Pathologic ; Convalescence ; Diabetes Mellitus ; Fibrosis ; Inflammation ; Malnutrition ; Natural History* ; Pancreas ; Pancreatitis ; Pancreatitis, Chronic* ; Steatorrhea