DUODENAL ULCER IN CHILDREN - 5 YEAR FOLLOW UP

Bak-Romaniszyn L. Czkwianianc E, Suski S., Kulig A, Planeta-Malecka I.

Department, of Pediatrics Military Medical University, Institute of Polish Mother's Memorial Hospital, Lodz, Poland.

Objective: Endoscopic and histological changes of mucosa in children with duodenal ulcers (DU) and H. pylori infection before, 4 weeks after treatment and 5 years after healing were analysed.

METHODS: The study group comprised 60 children with DU, aged 4- 17 years. The diagnosis was based on videoendoscopy.-histologic examination and urease test. Endoscopic changes of mucosa were classified in accordance with Sydney System criteria. Histologic specimens were assessed determining the activity and intensification of the inflammation. All children were subjected triple therapy bismuth, amoxicillin, metronidazole. After 5 years 49 children remained in observation.

RESULTS: Endoscopic examinations showed gastritis in 82% and duodenitis in 89% of children with DU and H.pylori infection. The most frequently observed were; erythematous-exudative gastritis and duodenitis with granulation of antral mucosa. Histologic examinations revealed chronic gastritis and duodenitis in 91% of children, in majority of them highly advanced. 4 weeks after treatment ulcer healing was observed in all children, eradication of H.pylori in 96%, decrease of endoscopic features of gastritis and duodenitis, histologic diminution of mucosal inflammation in over 20% of children. Follow up 5 years after the treatment showed duodenitis in 5% of the patients and no H.pylori infection.

CONCLUSIONS: In children with duodenal ulcer and H.pylori infection after H.pylori eradication decrease and modification of chronic gastritis and duodenitis was observed. Long term observation showed normal gastric mucose in all patients after 5 years.