Aspectos clínicos e histológicos da úlcera duodenal em crianças e adolescentes

Aspectos clínicos e histológicos da úlcera duodenal em crianças e adolescentes

Alternative title Clinical and histological features of duodenal ulcer in children and adolescents
Author Kawakami, Elisabete Autor UNIFESP Google Scholar
Machado, Rodrigo S. Autor UNIFESP Google Scholar
Fonseca, Jacqueline A. Autor UNIFESP Google Scholar
Patricio, Francy Reis da Silva Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract OBJECTIVE: To evaluate clinical and histological features of duodenal ulcer in children and adolescents. METHODS: Forty-three children with duodenal ulcer were prospectively and consecutively evaluated in a 6-year period (7.2 patients per year). Evaluation included clinical questionnaire focused on dyspeptic symptoms, physical examination, and digestive endoscopy with gastric biopsies for histological examination and Helicobacter pylori detection. RESULTS: Diagnostic age ranged from 4 years and 8 months to 17 years and 4 months (mean age: 12 years and 4 months). Abdominal pain was the main symptom (39/43, 90.7%), which was epigastric in 31/39, periumbilical in 7/39, and nocturnal in 27/39. Other symptoms were loss of appetite (32/43, 74.4%), vomiting (30/43, 69.8%), postprandial fullness (23/43, 53.5%), weight loss (22/43, 51.2%), and abdominal tenderness (19/43, 44.2%). Upper gastrointestinal bleeding occurred in 19/43 (44.2%), whereas anemia occurred in (21/43, 48.8%). Helicobacter pylori infection was detected in 41/43 (95.3%). All infected patients presented acute chronic gastritis in antrum, with lymphomononuclear infiltrate predominance in 92% of them. Eradication of the bacterium occurred in 68.3%. Ulcer healing occurred in all eradicated patients and in 89% of non-eradicated patients. CONCLUSION: Duodenal ulcer was associated with chronic gastritis due to Helicobacter pylori in the majority of patients. Many complications occurred, especially upper digestive bleeding.

OBJETIVO: Avaliar as características clínicas e histológicas de crianças e adolescentes com úlcera duodenal. MÉTODOS: Foram avaliadas prospectiva e consecutivamente 43 pacientes com úlcera duodenal ao longo de 6 anos (7,2 pacientes por ano). A avaliação consistiu de questionário clínico de sintomas dispépticos, exame físico e endoscopia digestiva com biópsias gástricas para exame histológico e detecção do Helicobacter pylori. RESULTADOS: A idade no diagnóstico variou de 4 anos e 8 meses a 17 anos e 4 meses (mediana = 12 anos e 4 meses). O sintoma mais freqüente foi dor abdominal (39/43, 90,7%): no epigástrio em 31/39, periumbilical em 7/39 e noturna em 27/39. Outros sintomas freqüentes foram: diminuição do apetite (32/43, 74,4%), vômitos (30/43, 69,8%), plenitude pós-prandial (23/43, 53,5%), perda de peso (22/43, 51,2%) e sensibilidade abdominal (19/43, 44,2%). Hemorragia digestiva alta ocorreu em 19/43 pacientes (44,2%), e anemia em 21/43 (48,8%). H. pylori foi detectado em 41/43 (95,3%), e todos esses pacientes apresentaram gastrite crônica ativa de antro, 92% deles com predomínio do infiltrado linfomononuclear. A erradicação da bactéria ocorreu em 68,3% dos pacientes infectados, mas houve cicatrização da lesão em 100% dos pacientes erradicados e em 89% dos não-erradicados. CONCLUSÃO: Úlcera duodenal foi associada à gastrite crônica por H. pylori na grande maioria dos pacientes. Houve grande freqüência de complicações, especialmente hemorragia digestiva alta.
Keywords Peptic ulcer
dyspepsia
Helicobacter pylori
children
Úlcera péptica
dispepsia
gastrite
Helicobacter pylori
Language Portuguese
Date 2004-08-01
Published in Jornal de Pediatria. Sociedade Brasileira de Pediatria, v. 80, n. 4, p. 321-325, 2004.
ISSN 0021-7557 (Sherpa/Romeo)
Publisher Sociedade Brasileira de Pediatria
Extent 321-325
Origin http://dx.doi.org/10.1590/S0021-75572004000500013
Access rights Open access Open Access
Type Article
SciELO ID S0021-75572004000500013 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/2173

Show full item record




File

Name: S0021-75572004000500013.pdf
Size: 147.7Kb
Format: PDF
Description:
Open file

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account