Klin Padiatr

[Peliosis hepatis with hepato-pulmonary syndrome]

Year 1998
Bindl L. Wagner N. Knopfle G. Gosseye S. Lentze MJ.
Zentrum fur Kinderheilkunde, Universitat Bonn, Deutschland.
Sinusoidal dilatation is a hallmark of peliosis hepatis, a rare vascular disorder that can be either drug induced or of infectious origin. Here we report a patient with peliosis hepatis of unknown etiology. An hepato-pulmonary syndrome developed which was reversible following liver transplantation.

[Intestinal infection, the most frequent cause of invagination in childhood: results of a 10-year clinical study]

Year 1998
Staatz G. Alzen G. Heimann G.
Klinik fur Radiologische Diagnostik, Universitatsklinikum, RWTH Aachen.
BACKGROUND: Intussusception is the most common cause of an acute abdomen in early childhood. 90% of all intussusceptions were thought to be idiopathic, because no lead points could be evaluated. PATIENTS: In our study we examined 148 children (93 boys and 55 girls) between 2. month and 18. years of age with 155 intussusceptions. METHOD: Besides epidemiological features and patients history we determined systematically all symptoms which occurred since the beginning of sickness. We performed ultrasound examinations before and after hydrostatic reduction with each child in order to find pathologic lead points. Microbiologic stool examination could be carried out at 99 specimen. RESULTS: 41 of 155 children with intussusception (26.5%) showed a pathologic finding next to the intussusception, with 29 children (18.7%) suffering from mesenteric lymphadenitis. 60.6% of examined stool specimen were abnormal. The most common germs were adenovirus, yersinia and staphylococcus aureus. Abdominal pain was the main symptom and was found in 72.6% of all children. 21% suffered from the classic trias abdominal pain, vomiting and rectal bleeding. 21.9% had diarrhea and 18% fever and signs of inflammation as unspecific symptoms. CONCLUSIONS: In our study we found mesenteric lymphadenitis as the most common lead point in intussusception. In conclusion with 60.6% pathologic germs in the examined stool specimen we assume gastrointestinal infection as the main cause of intussusception in childhood.

[Intestinal infection, the most frequent cause of invagination in childhood: results of a 10-year clinical study]

Year 1998
Staatz G. Alzen G. Heimann G.
Klinik fur Radiologische Diagnostik, Universitatsklinikum, RWTH Aachen.
BACKGROUND: Intussusception is the most common cause of an acute abdomen in early childhood. 90% of all intussusceptions were thought to be idiopathic, because no lead points could be evaluated. PATIENTS: In our study we examined 148 children (93 boys and 55 girls) between 2. month and 18. years of age with 155 intussusceptions. METHOD: Besides epidemiological features and patients history we determined systematically all symptoms which occurred since the beginning of sickness. We performed ultrasound examinations before and after hydrostatic reduction with each child in order to find pathologic lead points. Microbiologic stool examination could be carried out at 99 specimen. RESULTS: 41 of 155 children with intussusception (26.5%) showed a pathologic finding next to the intussusception, with 29 children (18.7%) suffering from mesenteric lymphadenitis. 60.6% of examined stool specimen were abnormal. The most common germs were adenovirus, yersinia and staphylococcus aureus. Abdominal pain was the main symptom and was found in 72.6% of all children. 21% suffered from the classic trias abdominal pain, vomiting and rectal bleeding. 21.9% had diarrhea and 18% fever and signs of inflammation as unspecific symptoms. CONCLUSIONS: In our study we found mesenteric lymphadenitis as the most common lead point in intussusception. In conclusion with 60.6% pathologic germs in the examined stool specimen we assume gastrointestinal infection as the main cause of intussusception in childhood.

[Recurrent pancreatitis in pediatric ulcerative colitis--a case report]

Year 1998
Langler A. Baumgart H. Geissler J. Tautz C.
Kinderabteilung am Gemeinschaftskrankenhaus Herdecke, Universitat Witten/Herdecke.
We report on a 12 years old girl with ulcerative colitis, who after a two years course of her disease developed a concomitant idiopathic pancreatitis. We discuss the causes of acute pancreatitis in childhood in view of the presented case summarizing the current literature. In the literature we found only two other children with ulcerative colitis and idiopathic pancreatitis. Both patients were colectomised as our patient did. Six months after colectomy she is still free of symptoms.

[Recurrent hemorrhage from a duodenal ulcer in a 5-year-old healthy boy. A case report]

Year 1998
Hanke S. Gobel P. Weitzel A. Saeger HD. Roesner D.
Klinik und Poliklinik fur Kinderchirurgie, Universitatsklinikum Carl Gustav Carus, Technischen Universitat Dresden.
Peptic ulcers in infants are rare. We report a 5-year-old boy who was admitted with recurrent bleeding from a huge duodenal ulcer. There were no concomitant disease and no preceding symptoms discovered. The only clinical symptom was bloody stool of light red color what led to diagnostic problems. Upper gastrointestinal bleeding was not considered initially. Short transit time through the gut may suggest a bleeding source within the lower intestine. Gastroscopy was performed delayed. Injection therapy of the ulcer once using fibrin sealant was followed by definite cessation of bleeding. Helicobacter pylori was not found. Hormone producing tumors could be excluded. There was a psycho-social situation of stress recognizable for the infant. The pathogenic mechanism of peptic ulceration due to psycho-social stress is unknown and somewhat doubtful at all. Peptic ulcer disease in infants and children should more often be considered when dealing with diffuse abdominal pain or with gastrointestinal bleeding.