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Gastrointestinal bleeding children

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https://www.readbyqxmd.com/read/28924528/near-fatal-gastrointestinal-hemorrhage-in-a-child-with-medulloblastoma-on-high-dose-dexamethasone
#1
Derek Yecies, Daniel Tawfik, Jennifer Damman, Chad Thorson, David S Hong, Gerald A Grant, Rachel Bensen, Mihaela Damian
A four-year-old female was admitted to a university-based children's hospital with a newly-diagnosed posterior fossa tumor. She was started on famotidine and high-dose dexamethasone and underwent gross total resection of a medulloblastoma. She was continued on dexamethasone and famotidine. She exhibited postoperative posterior fossa syndrome and was started on enteral feeds via the nasoduodenal tube. She had small gastrointestinal bleeds on postoperative days eight, 11, and 18, and was found to have a well-circumscribed posterior duodenal ulcer...
July 7, 2017: Curēus
https://www.readbyqxmd.com/read/28894313/need-for-a-randomized-controlled-trial-of-stress-ulcer-prophylaxis-in-critically-ill-children-a-canadian-survey
#2
Mark Duffett, Karen Choong, Jennifer Foster, Elaine Gilfoyle, Jacques Lacroix, Deborah J Cook
BACKGROUND: Stress ulcer prophylaxis is commonly used in pediatric critical care, to prevent upper gastrointestinal bleeding. The most frequently used agents are histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs). The risk-benefit ratio for stress ulcer prophylaxis is uncertain, because data from randomized clinical trials (RCTs) on the effectiveness and harms of prophylaxis in children are limited. OBJECTIVE: To describe the views of Canadian pediatric intensivists about a future RCT of stress ulcer prophylaxis...
July 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28887788/the-clinical-and-serological-profile-of-pediatric-dengue
#3
Sujatha Ramabhatta, Saravanan Palaniappan, Navya Hanumantharayappa, Shaik Vajidunnisa Begum
OBJECTIVE: To classify suspected dengue into dengue, dengue with warning signs and severe dengue, based on clinical features as per the revised WHO guidelines with special emphasis on serology. METHODS: It was a prospective cross-sectional study for five years from 2011-2016 in a tertiary care medical college hospital in Bangalore. All cases of fever of three to five days duration with symptoms like dengue were enrolled for the study. They were categorized into three groups as per the Revised WHO 2012 criteria...
September 8, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28834452/reminiscing-on-remnants-imaging-of-meckel-diverticulum-and-its-complications-in-adults
#4
Argha Chatterjee, Carla Harmath, Camila Lopes Vendrami, Nancy A Hammond, Pardeep Mittal, Riad Salem, Frank H Miller
OBJECTIVE: Meckel diverticulum may become symptomatic if it is complicated by hemorrhage, intestinal obstruction, diverticulitis, or tumor. Although classically described in children, it is often missed in adults because of lack of suspicion and difficulty in detection. The purpose of this article is to review the imaging findings and management of Meckel diverticulum and its complications. CONCLUSION: Although it is infrequently encountered incidentally, Meckel diverticulum should be considered especially when interpreting examinations for abdominal pain, small-bowel obstruction, and gastrointestinal bleeding...
August 23, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28814423/portal-hypertension-and-its-management-in-children
#5
REVIEW
Tassos Grammatikopoulos, Patrick James McKiernan, Anil Dhawan
Portal hypertension (PHT), defined as raised intravascular pressure in the portal system, is a complication of chronic liver disease or liver vascular occlusion. Advances in our ability to diagnose and monitor the condition but also predict the risk of gastrointestinal bleeding have enabled us to optimise the management of children with PHT either at a surveillance or at a postbleeding stage. A consensus among paediatric centres in the classification of varices can be beneficial in streamlining future paediatric studies...
August 16, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28796070/clinical-characteristics-of-meckel-diverticulum-in-children-a-retrospective-review-of-a-15-year-single-center-experience
#6
Xiao-Kun Lin, Xiao-Zhong Huang, Xiao-Zhou Bao, Na Zheng, Qiong-Zhang Xia, Cong-de Chen
Meckel diverticulum is the most prevalent congenital abnormality of the gastrointestinal tract in children. The aim of this study was to review and analyze clinical data on the diagnosis and management of Meckel diverticulum in pediatric patients. The records of 102 pediatric patients (<14 years old) who underwent surgery for Meckel diverticulum at our institute between 2001 and 2015 were reviewed. Clinical, imaging, laboratory, surgical, and pathological data were recorded. The series comprised 65 males and 37 females with a median age of 5...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28668417/mr-enterography-in-paediatric-patients-with-obscure-gastrointestinal-bleeding
#7
Emanuele Casciani, Giovanni Di Nardo, Simone Chin, Gabriele Masselli, Elisabetta Polettini, Salvatore Oliva, Denis A Cozzi, Salvatore Cucchiara, Gianfranco Gualdi
OBJECTIVES: To evaluate the performance of Magnetic Resonance enterography (MRE) in the diagnostic work-up of children presenting with obscure gastrointestinal bleeding (OGIB). MATERIALS AND METHODS: From January 2014 to January 2016, a single-centre prospective study was performed on all children between 0 and 16 years of age referred to the radiology department for OGIB. Each child underwent MRE examination after negative oesophagogastroduodenoscopy and ileocolonoscopy...
August 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28614174/minimally-invasive-cholecystolithotomy-to-treat-cholecystolithiasis-in-children-a-single-center-experience-with-23-cases
#8
Xiaokun Lin, Jingli Cai, Jisheng Wang, Congde Chen, Guorong He, Yijiang Han
OBJECTIVE: Minimally invasive cholecystolithotomy is recently popularized treatment that may offer advantages over laparoscopic cholecystectomy, especially in China. However, there are few reports concerning the use of this technique in the pediatric population. This report describes our initial experience with minimally invasive cholecystolithotomy using laparoscopy combined with choledochoscopy to treat cholecystolithiasis in children. MATERIALS AND METHODS: A retrospective review of 23 pediatric patients with cholecystolithiasis who underwent minimally invasive cholecystolithotomy using laparoscopy combined with choledochoscopy from January 2009 to December 2015 was performed...
June 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28614113/role-of-octreotide-in-pediatric-gastrointestinal-bleeding-secondary-to-angiodysplasia-in-children-with-right-heart-failure
#9
Kanika Puri, Robert Caldwell, Jean P Molleston
OBJECTIVES: Angiodysplasia is a relatively uncommon cause of GI bleeding in children and may be seen in right heart failure. Octreotide has been used successfully in adult patients with gastrointestinal bleeding due to angiodysplasias. METHODS: We describe two patients who had congenital heart disease with right heart failure and gastrointestinal bleeding from angiodysplasia. RESULTS: Angiodysplasia lesions were documented on traditional endoscopy and capsule endoscopy...
June 13, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28601031/delayed-diagnosis-of-esophageal-foreign-body-a-case-report
#10
Salem Yahyaoui, Imen Jahaouat, Ines Brini, Azza Sammoud
INTRODUCTION: Foreign body (FB) ingestion, a common and serious problem in children, can present with a wide variety of symptoms. This paper describes and discusses the case of an esophageal foreign body (EFB), in which the patient presented with primarily respiratory clinical signs causing delayed diagnosis. PRESENTATION OF CASE: A six month old boy presented with three months history of harsh cough, stridor and pulmonary congestion. He was repeatedly treated with steroids and antibiotics...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28597002/littre-hernia-a-rare-case-of-an-incarcerated-meckel-s-diverticulum
#11
Brian Malling, Andreas Aarenstrup Karlsen, Jesper Hern
A Meckel's diverticulum is a remnant of the vitelline duct, which leads to the formation of a true diverticulum containing all layers of the small intestine. The diverticulum can contain ectopic gastric, duodenal or pancreatic tissue and is the most common congenital anomaly of the gastrointestinal tract with estimates of prevalence ranging from 0.3% to 3%. The condition is usually clinically silent. In children the most common complication is gastrointestinal bleeding caused by ulceration due to the acid secretion by ectopic gastric mucosa...
April 2017: Ultrasound International Open
https://www.readbyqxmd.com/read/28585786/-results-of-the-mesoportal-bypass-rex-shunt-in-the-treatment-of-idiopathic-extrahepatic-portal-vein-obstruction-in-children
#12
E Domínguez Amillo, C De la Torre Ramos, A Andrés Moreno, J L Encinas Hernández, F Hernández Oliveros, M López Santamaría
BACKGROUND: Extrahepatic portal vein obstruction (EPVO) is the principal cause of portal hypertension in children. The objective of this study was to analyze the capacity of the surgical technique that creates a mesoportal shunt to treat changes caused by EPVO. METHODS: Retrospective review of patients with idiopathic EPVO who underwent a mesoportal shunt and analysis of the changes in the number of leucocytes, platelets, prothrombin time and spleen size one year after the surgery...
January 25, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28556542/long-term-outcomes-of-de-novo-autoimmune-hepatitis-in-pediatric-liver-transplant-recipients
#13
Udeme D Ekong, Patrick McKiernan, Mercedes Martinez, Steven Lobritto, Deirdre Kelly, Vicky L Ng, Estella M Alonso, Yaron Avitzur
The long-term course and outcome of DAIH is unknown. A retrospective multicenter study assessing associations and long-term consequences of DAIH developing in a transplanted allograft is presented. Children with DAIH were followed from diagnosis until death, re-LT, or transfer of care and for a minimum of 1 year. A total of 31 patients of 1833 (1.7%) LT were identified; 29 followed for a median of 7.1 years (range, 1.6-15); 52% had no rejection preceding diagnosis of DAIH. Transaminases fell following treatment with steroids and antimetabolites (ALT 108 vs 39 U/L (P=...
September 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28540196/significance-of-platelet-count-in-children-admitted-with-bronchiolitis
#14
Amar Al Shibli, Najla Alkuwaiti, May Hamie, Dima Abukhater, Muhammad B Noureddin, Abdulla Amri, Salwa Al Kaabi, Aysha Al Kaabi, Mariam Harbi, Hassib Narchi
AIM: To determine the true prevalence of thrombocytosis in children less than 2 years of age with bronchiolitis, its association with risk factors, disease severity and thromboembolic complications. METHODS: A retrospective observational medical chart review of 305 infants aged two years or less hospitalized for bronchiolitis. Clinical outcomes included disease severity, duration of hospital stay, admission to pediatric intensive care unit, or death. They also included complications of thrombocytosis, including thromboembolic complications such as cerebrovascular accident, acute coronary syndrome, deep venous thrombosis, pulmonary embolus, mesenteric thrombosis and arterial thrombosis and also hemorrhagic complications such as bleeding (spontaneous hemorrhage in the skin, mucous membranes, gastrointestinal, respiratory, or genitourinary tracts)...
May 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28533916/pediatric-intensive-care-stress-ulcer-prevention-pic-up-a-protocol-for-a-pilot-randomized-trial
#15
Mark Duffett, Karen Choong, Jennifer Foster, Elaine Gilfoyle, Jacques Lacroix, Nikhil Pai, Lehana Thabane, Deborah J Cook
BACKGROUND: Despite sparse pediatric data on effectiveness, the majority of critically ill children receive medications to prevent gastrointestinal (GI) bleeding. Stress ulcer prophylaxis may have unintended consequences-increasing the risk of nosocomial infections-which may be more serious and common than the bleeding which these drugs are prescribed to prevent. Randomized controlled trials (RCTs) in pediatric critical care are exceptionally challenging to complete, thus a rigorous pilot RCT is crucial...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28511401/jejunal-gastric-heterotopia-causing-multiple-strictures-and-perforation-peritonitis-a-case-report-with-review-of-literature
#16
M Vani, Ajit Nambiar, K Geetha, Byju Kundil
Gastric heterotopias beyond the ligament of Treitz though rare, should be thought of in the differential diagnosis of polypoid lesions presenting with gastrointestinal bleed or obstructive symptoms especially in children and in the young. Here is a 24-year-old male with multifocal jejunal gastric heterotopias causing multiple strictures and perforation peritonitis. Patient presented with acute abdomen pain and an emergency laparotomy was performed revealing jejunum with multiple strictures and perforation, followed by jejunal resection...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28502437/gastrointestinal-bleeding-and-management
#17
REVIEW
Anita K Pai, Victor L Fox
There is a broad clinical spectrum of gastrointestinal bleeding in children, ranging from subtle laboratory findings to dramatic clinical presentations. This review provides a framework for the evaluation and management of gastrointestinal hemorrhage for pediatricians. It outlines strategies for obtaining a tailored patient history and conducting a thorough physical examination that can shed light on the location, severity, and likely etiology of bleeding. It appraises blood tests, radiologic tools, and endoscopic modalities frequently used to identify and control a source of bleeding...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28489830/-clinical-and-laboratory-characteristics-of-patients-with-pulmonary-hypertension-and-pulmonary-vascular-complications-hospitalized-at-the-instituto-nacional-de-salud-del-ni%C3%A3-o
#18
Alexis Jose Ormeño Julca, Carlos Melchor Alvarez Murillo, Pedro Miguel Amoretti Alvino, Angel Aladino Florian Florian, Rosa Aurora Castro Johanson, Maria Danisa Celi Perez, Olga Rocío Huamán Prado
The hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPHN) are distinct pulmonary vascular complications of portal hypertension (PHT) and are associated with increased morbidity and mortality. OBJECTIVES: To describe the clinical and laboratory characteristics of patients with pulmonary hypertension and pulmonary vascular complications hospitalized at the Instituto Nacional de Salud del Niño. MATERIALS AND METHODS: We included patients with HTP hospitalized from January 2012 to June 2013 and that during its evolution progressed with SHP or HTPP...
January 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28444452/ebola-virus-disease-in-children-during-the-2014-2015-epidemic-in-guinea-a-nationwide-cohort-study
#19
Mahamoud Sama Chérif, Nut Koonrungsesomboon, Diénaba Kassé, Sékou Ditinn Cissé, Saliou Bella Diallo, Fatoumata Chérif, Facély Camara, Alpha Koné, Eleonor Fundan Avenido, Mandiou Diakité, Mamadou Pathé Diallo, Edouard Le Gall, Mohamed Cissé, Juntra Karbwang, Kenji Hirayama
The most recent epidemic of Ebola virus disease (EVD) has resulted in more than 11,000 deaths in West Africa. It has threatened child health in the affected countries, including Guinea. This nationwide retrospective cohort study included all children under 20 years of age with laboratory-confirmed EVD in Guinea during the 2014-2015 Ebola outbreak for analysis. Of 8,448 children with probable or suspected EVD, 695 cases were laboratory-confirmed EVD. The overall case fatality rate (CFR) was 62.9%. Pediatric patients with younger age had a significantly higher rate of death (adjusted OR = 0...
April 25, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28438745/management-of-chronic-pain-using-complementary-and-integrative-medicine
#20
REVIEW
Lucy Chen, Andreas Michalsen
Complementary and integrative medicine (CIM) encompasses both Western-style medicine and complementary health approaches as a new combined approach to treat a variety of clinical conditions. Chronic pain is the leading indication for use of CIM, and about 33% of adults and 12% of children in the US have used it in this context. Although advances have been made in treatments for chronic pain, it remains inadequately controlled for many people. Adverse effects and complications of analgesic drugs, such as addiction, kidney failure, and gastrointestinal bleeding, also limit their use...
April 24, 2017: BMJ: British Medical Journal
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