RESUMO
Gastric ulcers in children are often seen as a result of an imbalance between nocive factors and the resistance of the mucosa. Glanzmann's thromboastenia is a defect in platelet aggregation and its nature may be associated to local factors which precipitate or perpetuate bleeding. Prostaglandins are hormones of local action which inhibit the secretion of acid and therefore protect the mucosa. We report a case of an 18 year old male youngster with Glanzmann's thromboastenia and a gastric ulcer previously unsuccessfully treated with cimetidine, aluminum hydroxide solution, ranitidine, sucralfate and later controlled with PGE2. In sum, the usefulness of the cytoprotecting effects of the prostaglandins are successfully evaluated in a young man with platelet aggregation abnormalities.
Assuntos
Antiulcerosos/uso terapêutico , Prostaglandinas E Sintéticas/uso terapêutico , Úlcera Gástrica/tratamento farmacológico , Úlcera Gástrica/etiologia , Trombastenia/complicações , Adolescente , Doença Crônica , Emprostila , Humanos , MasculinoRESUMO
We study 22 children with clinical symptoms of gastroesophageal reflux. The main manifestations were: frequent vomiting, failure to thrive and repetitive pneumonia. In all of them we perform barium esophagogram (SEGD) with fluoroscopy, esophageal manometry (EM) and a four hours intraesophageal pH measurement. Thirteen of the twenty two children present a pathologic reflux (ERGE); in 16 we found SEGD that show reflux; three of them had an abnormal EM, the other 13 were normal. Seven patients showed alteration of the intraesophageal pH measurement. In conclusion the intraesophageal pH measurement in short period of time (4 hours) is a good method in the diagnosis of patients with ERGE.
Assuntos
Refluxo Gastroesofágico/diagnóstico , Concentração de Íons de Hidrogênio , Criança , Pré-Escolar , Esôfago , Feminino , Refluxo Gastroesofágico/diagnóstico por imagem , Refluxo Gastroesofágico/fisiopatologia , Humanos , Lactente , Masculino , Manometria , Valor Preditivo dos Testes , Radiografia , Fatores de TempoRESUMO
Paucity of intrahepatic bile ducts is considered part of the differential diagnosis of cholestatic syndromes in infancy. The purpose of this work is to inform the experience at the Hospital Infantil de Mexico Federico Gómez in the last few years on this entity. We reviewed the clinical charts as well as the biopsies of 31 patients with paucity of intrahepatic bile ducts. We find a slight male preponderance; the vast majority of patients were under three months of age. Cholestasis was the most frequent finding with significant clinicopathologic correlation. The remaining findings were similar to those previously reported, except for a peculiar distortion of the hepatic architecture which may be secondary to the hypoplastic development of the biliary tree. Finally, it is possible that the failure to thrive observed in this patient may commence in utero.