Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Çocukluk Çağı Peptik Ülser ve Erozyon Olgularının Değerlendirilmesi: Son 6 Yıllık Deneyim: Tanımlayıcı Araştırma
Evaluation of Childhood Peptic Ulcer and Erosion: Experience of the Last 6 Years: Descriptive Research
Hakan SALMANa, Mustafa AKÇAMa
aSüleyman Demirel Üniversitesi Tıp Fakültesi, Çocuk Gastroenteroloji, Hepatoloji ve Beslenme BD, Isparta, Türkiye
Turkiye Klinikleri J Pediatr. 2022;31(3):185-9
doi: 10.5336/pediatr.2022-90640
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, kliniğimizdeki peptik ülser ve/veya erozyonlu çocukları değerlendirmek ve risk faktörlerini araştırmaktır. Gereç ve Yöntemler: Ocak 2015-2021 tarihleri arasında çeşitli şikâyetlerle endoskopi yapılarak ülser ve/veya erozyon tanısı alan çocuklar geriye dönük olarak incelendi. Sosyodemografik özellikler, başvuru şikâyetleri, ilaç kullanımı, eşlik eden sistemik hastalık, koroziv madde alımı, ailede peptik hastalık öyküsü ve Helicobacter pylori varlığı araştırıldı. Bulgular: Endoskopi yapılan 1.263 olgunun 89'unda (%7) ülser ve/veya erozyon saptandı. Olguların 44'ü kız (%49,4), yaş ortalamaları 12,37±4,78 (1 ay-18 yıl) idi. Geliş şikâyetleri en sık 52'sinde (%58,4) epigastrik ağrı ve 22'sinde (%24,7) gastrointestinal sistem kanamasıydı. Gastrik ülser 21 (%23,6), gastrik erozyon 23 (%26), duodenal ülser 32 (%36), duodenal erozyon 10 (%11), hem gastrik ülser hem duodenal ülser 3 (%3,3) olguda saptandı. Olguların 27'sinde (%30,3) H. pylori pozitifti. H. pylori pozitiflerde duodenal ülser ve antral nodülarite görülme sıklığı ile H. pylori pozitiflerin yaş ortalaması negatiflere göre yüksekti (p=0,011, p=0,007, p=0,000). Olguların 21'inde (%23,6) ilaç kullanım öyküsü vardı. İlaç kullananlarda %54,5, kullanmayanlarda %16,7 ülsere bağlı gastrointestinal kanama saptandı (p=0,009). H. pylori negatif ve ilaç kullanım öyküsü olmayan (idiyopatik) 44 (%49,4) hasta vardı. Sonuç: Çocuklarda peptik ülser ve erozyonlar nadir değildir. H. pylori pozitiflerde duodenal ülser ve antral nodülarite görülme sıklığı özellikle ergenlik çağında yüksekti. Ülsere bağlı gastrointestinal kanama oranı ilaç kullananlarda fazlaydı. H. pylori negatif ve ilaç kullanım öyküsü olmayan (idiyopatik) olgular da dikkate değerdir.

Anahtar Kelimeler: Çocuk; gastrointestinal kanama; Helicobacter pylori; karın ağrısı; peptik ülser
ABSTRACT
 Objective: To evaluate the children with peptic ulcer and/or erosion and to investigate risk factors. Material and Methods: Children who diagnosed with ulcers and/or erosions by endoscopy with various complaints between January 2015 and 2021 were reviewed, retrospectively. Sociodemographic characteristics, complaints at admission, drug use, concomitant systemic disease, corrosive substance intake, family history of peptic disease, presence of Helicobacter pylori were investigated. Results: Ulcer and/or erosion were detected in 89 (7%) of 1,263 cases evaluated by endoscopy. 44 of the cases were girls (49.4%), mean age was 12.37±4.78. The most common presentation complaints were epigastric pain in 52 patients (58.4%) and gastrointestinal bleeding in 22 (24.7%) patients. Gastric ulcer in 21 (23.6%) cases, gastric erosion in 23 (26%), duodenal ulcer in 32 (36%), duodenal erosion in 10 (11%), and both gastric and duodenal ulcer were detected in 3 (3.3%) cases. H. pylori was positive in 27 (30.3%) of the cases. The mean age, incidence of duodenal ulcer and antral nodularity were higher in H. pylori positive patients than negative patients (p=0.000; p=0.011; p=0.007, respectively). There was history of drug use in 21 (23.6%) cases. Ulcer-related gastrointestinal bleeding was detected in 54.5% of the drug users and 16.7% of the non-users (p=0.009). There were 44 (49.4%) patients who were H. pylori negative and had no history of drug use (idiopathic). Conclusion: Peptic ulcers and erosions are not uncommon in children. The incidence of duodenal ulcer and antral nodularity in H. pylori positives was especially high in adolescence. The rate of gastrointestinal bleeding due to ulcer was higher in drug users. H. pylori-negative and drug-negative (idiopathic) cases are also noteworthy.

Keywords: Child; gastrointestinal hemorrhage; Helicobacter pylori; abdominal pain; peptic ulcer
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