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Comparison of double balloon enteroscopy in adults and children

World Journal of Gastroenterology 2013年第29期19卷 4726-4731页

作者： odul egritas gurkan Tarkan Karakan Ibrahim Dogan Buket Dalgic Selahattin Unal Department of Pediatric Gastroenterology School of Medicine Gazi University 06500 Ankara Turkey Department of Gastroenterology School of Medicine Gazi University 06500 Ankara Turkey

AIM: To compare results of double balloon enteroscopy (DBE) procedures in pediatric and adult patients. METHODS: The medical files of patients who underwent DBE at Gazi University School of Medicine, Ankara, Turkey between 2009 and 2011 were examined retrospectively. Adult and pediatric patients were compared according to DBE indications, procedure duration, final diagnosis, and complications. DBE procedures were performed in an operating room under general anesthesia by two endoscopists. An oral or anal approach was preferred according to estimated lesion sites. Overnight fasting of at least 6 h prior to the start of the procedure was adequate for preprocedural preparation of oral DBE procedures. Bowel cleansing was performed by oral administration of sennosides A and B solution, 2 mL/kg, and anal saline laxative en-ema. The patients were followed up for 2 h after the procedure in terms of possible complications. RESULTS: DBE was performed in 35 patients (5 pediatric and 30 adult). DBE procedures were performed for abdominal pain, chronic diarrhea, bleeding, chronic vomiting, anemia, and postoperative evaluation of anastomosis. Final diagnosis was diffuse gastric angiodysplasia (n = 1); diffuse jejunal angiodysplasia (n = 1); ulceration in the bulbus (n = 1); celiac disease (n = 1); low differentiated metastatic carcinoma (n = 1); PeutzJeghers syndrome (n = 1); adenomatous polyp (n = 1) and stricture formation in anastomosis line (n = 1). During postprocedural follow-up, abdominal pain and elevated amylase levels were noted in three patients and one patient developed abdominal perforation. CONCLUSION: With the help of technological improvements, we may use enteroscopy as a safe modality more frequently in younger and smaller children.

关键词： Double-balloon enteroscopy Small bowel disease Polyp Angiodysplasia Peutz-Jeghers syndrome

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Differential diagnosis in ulcerative colitis in an adolescent: Chronic granulomatous disease needs extra attention

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World Journal of Gastrointestinal Pathophysiology 2017年第2期8卷 87-92页

作者： Daniel Kotlarz odul egritas gurkan Zehra Sule Haskologlu Ozgur Ekinci Aysel Aksu Unlusoy Neslihan Gürcan Kaya Jacek Puchalka[Deceased] Cristoph Klein Buket Dalgic Department of Pediatrics Dr.Von Hauner Children’s Hospital Ludwig-Maximilians-University Department of Pediatric Gastroenterology Gazi University School of Medicine Department of Pediatric Immunology and Allergy Ankara University School of Medicine Department of Pathology Gazi University Faculty of Medicine

Chronic granulomatous disease(CGD) is a primary immune deficiency that is commonly diagnosed under the age of 5 years(95%) and is rarely seen in adulthood. CGD may manifest as inflammatory bowel disease(IBD) in childhood. Without proper diagnosis, these patients may be monitored for years as IBD; some may even be regarded as steroid-resistant ulcerative colitis(UC) and end up having a colectomy. In this case report, we described a patient who had been followedup for years as UC and subsequently underwent colectomy, but was finally diagnosed in adulthood as primary immune deficiency.

关键词： Ulcerative colitis Chronic granulomatous disease Inflammatory bowel disease Immunodeficiency Childhood

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