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Smaranda Diaconescu

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

ETIOLOGIA SANGERARILOR GASTROINTESTINALE LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 1, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

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ETIOLOGIA SANGERARILOR GASTROINTESTINALE LA COPIL

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REZUMAT

Obiective. Identificarea caracterelor clinice, endoscopice, etiologice la copiii diagnosticaţi cu hemoragie digestivă superioară şi inferioară.

Material şi metodă. S-a efectuat un studiu retrospectiv descriptiv pe o perioadă de 3 ani (ianuarie 2010- decembrie 2012) pe 107 copiii cu vârsta între 1 şi 18 ani, internaţi pentru hemoragii digestive în Spitalului Clinic de Copii „Sf. Maria“ Iaşi. Lotul de studiu nu cuprinde hemoragii digestive din urgenţe chirurgicale, boli infecţioase, boli intestinale cu mecanism imunologic sau toxic. Analiza retrospectivă individualizată prin studiul foii de observaţie a cuprins date anamnestice, clinice, endoscopice şi histologice orientate pentru diagnosticul etiologic al hemoragiilor digestive. Toţi pacienţii au fost investigaţi prin endoscopie digestivă superioară/colonoscopie după ce procedura a fost explicată şi s-a obţinut consimţământul informat.

Rezultate. Din lotul de 107 copii luaţi în studiu 39 (36,4%) au reprezentat hemoragia digestivă superioară (HDS), dintre care 6 cazuri (5,1% ) de cauză variceală iar 33 (94,8%) de cauză non variceală; şi 68 (63,5%) au prezentat hemoragia digestivă inferioară (HDI). În etiologia HDS gastrita erozivă a reprezentat 12 (30,8%) cazuri, esofagita 6 (15,4%), duodenită 6 (15,4%), ulcerul duodenal 4 (10,3%), ulcerul gastric 2 (5,1%), sindrom Mallory Weiss 1 (2,6%), etiologie multiplă 6 (15,4%) cazuri. Principalele aspecte etiologice ale HDI au fost polipii colo-rectali în 28 (41,2%) cazuri, colita ulcerativă 14 (20,6%), leziuni nespecifice 12 (17,6%), fisuri anale 9 (13,4%), sindroamele de polipoză intestinală 3 (4,4%), malformaţie vasculară 1 (1,5%), diverticul rectal 1 (1,5%) caz. S-au practicat intervenţii endoscopice concomitente în cazul polipilor colo-rectali.

Concluzii. Hemoragia digestivă inferioară a fost cea mai frecventă, corelată cu cauze minore: polipii colorectali, fisuri anale, leziuni nespecifice. Hemoragia digestivă non-variceală forma cea mai frecventă s-a asociat cu gastrita erozivă, esofagita, duodenita, ulcerul gastric. Endoscopia digestivă s-a dovedit a fi o investigaţie utilă în diagnosticul hemoragiilor digestive şi cu aport terapeutic în anumite cazuri.

Cuvinte cheie: copil, sângerare gastrointestinală, etiologie, endoscopie, colonoscopie

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ETIOLOGY OF GASTROINTESTINAL BLEEDING IN CHILDREN

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 1, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
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DOAJ
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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

ETIOLOGY OF GASTROINTESTINAL BLEEDING IN CHILDREN

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ABSTRACT

Objectives. Identification of clinical, endoscopic, etiological characteristic of children diagnosed with upper and lower gastrointestinal bleeding.

Material and methods. It was conducted a descriptive retrospective study over a 3 year period (January 2010 to December 2012) on 107 children aged 1-18 years hospitalized for gastrointestinal bleeding in ”St. Mary” Children’s Emergency Hospital, Iasi. The study group does not include gastrointestinal bleeding from surgical emergencies, infectious diseases, intestinal diseases with immunological or toxic mechanism. Individualized retrospective analysis included historical data, clinical, endoscopic and histological targeted for etiologic diagnosis of gastrointestinal bleeding. All patients were investigated by upper gastrointestinal endoscopy/colonoscopy after the procedure was explained and informed consent was obtained.

Results. From the batch of 107 children, 39 (36.4%) presented with upper gastrointestinal bleeding (UGIB) 6 (5.1%) was variceal, non-variceal in 33 (94.4%) cases, and 68 (63.5%) presented with lower gastrointestinal bleeding (LGIB). The main etiologycal aspect of UGB was erosive gastritis 30.8%, oesophagitis in 15.4%, duodenitis in 15.4%, gastric and duodenal ulcers 5,1% and respectivily 10.3% of cases, Mallory-Weiss syndrome in 2.6%, multiple etiology in 10 cases 15.4%. Causes of LGIB were colorectal polyps in 41.2.%, ulcerative colitis 20.6%, non specific lessions in 17.6% anal fissures 13.2%, intestinal polyposis 4.4 %, rectal diverticula 1.5% and vascular malformations 1.5%. It was practiced concomitent endoscopic surgery for rectal polyps.

Conclusions. Lower gastrointestinal bleeding was the most common causes related to minor conditions: colorectal polyps, anal fissures, nonspecific lesions. Non-variceal gastrointestinal bleeding the most common form associated with erosive gastritis, esophagitis, duodenal ulcer, gastric ulcer. Endoscopy proved to be a useful investigation in the diagnosis of gastrointestinal bleeding and a therapeutic useful tool in certain cases.

Keywords: gastrointestinal bleeding, children, etiology, endoscopy, colonoscopy

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ABORDAREA MULTIDISCIPLINARA A CONSTIPATIEI CRONICE ASOCIATA CU INCONTINENTA FECALA LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 1, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
Scopus
NLM Catalog
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Google Academic
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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

ABORDAREA MULTIDISCIPLINARA A CONSTIPATIEI CRONICE ASOCIATA CU INCONTINENTA FECALA LA COPIL

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REZUMAT

Constipaţia este un simptom comun în practica clinică. Definiţia include frecvenţa anormală a tranzitului, dificultate în timpul defecării şi consistenţă anormală a scaunului. Metodele de diagnostic limitate precum şi numeroasele afecţiuni care conduc la apariţia simptomatologiei, duc la creşterea numărului de cazuri cu rezistenţa la tratament. Tratamentul include abordări dietetice şi comportamentale, terapie farmacologică şi în cazuri atent selectate intervenţie chirurgicală. Tratamentul chirurgical este recomandat la pacienţii cu constipaţie severă rezistentă la tratamentul conservator. Confirmarea indicaţiei pentru tratament chirurgical necesită studii privind tranzitul colonic, funcţia de defecare, precum şi efectuarea manometriei anorectale. De aceea, colaborarea strânsă între pediatru, gastroenterolog şi chirurgul pediatru este absolut necesară pentru o evaluare preoperatorie atentă şi corectă a funcţiei gastro-intestinale. Complicaţiile postoperatorii includ obstrucţie intestinală, dureri abdominale, meteorism şi diaree. Eficacitatea intervenţiei chirurgicale şi prevalenţa complicaţiilor postoperatorii sunt determinate de evaluarea atentă preoperatorie a funcţiei gastro-intestinale.

Cuvinte cheie: constipaţie organică, encomprezis, tratament chirurgical, copil

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MULTIDISCIPLINARY APPROACH TO CHRONIC CONSTIPATION ASSOCIATED WITH FECAL INCONTINENCE IN CHILDREN

SELECT ISSUE

Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 1, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
Scopus
NLM Catalog
Ebsco Host - Medline
Google Academic
Semantic Scholar

HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

MULTIDISCIPLINARY APPROACH TO CHRONIC CONSTIPATION ASSOCIATED WITH FECAL INCONTINENCE IN CHILDREN

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ABSTRACT

Constipation is a common symptom in clinical practice. Definition include abnormal transit difficulty during defecation and abnormal stool consistency. Limited diagnostic methods and the many diseases that lead to symptoms, leading to more cases of drug resistance. Treatment includes dietary and behavioral approaches, pharmacological therapy and surgery in carefully selected cases. Surgery is recommended in patients with severe constipation resistant to conservative treatment. Confirmation of indication for surgical treatment requires colonic transit studies, defecation function and conducting anorectal manometry. Therefore, a close collaboration between pediatric gastroenterologists and surgeon pediatricians is essential for the careful preoperative evaluation and gastrointestinal function. Postoperative complications include intestinal obstruction, abdominal pain, flatulence and diarrhea. The effectiveness of surgery and prevalence of postoperative complications are determined by a careful preoperative evaluation of the gastrointestinal function.

Keywords: organic constipation, encomprezis, surgical treatment, child

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