Duodenitis in children: correlation of radiologic findings with endoscopic and pathologic findings.

Publication/Presentation Date

1-1-1998

Abstract

PURPOSE: To determine the accuracy of barium studies in the diagnosis of duodenitis in children.

MATERIALS AND METHODS: Seventy-five children (45 boys and 30 girls; mean age, 9 years) underwent upper gastrointestinal (GI) examinations. Twenty-four of the children had biopsy-proved duodenitis, and 51 were healthy control subjects. Radiologic findings were reviewed by two experienced, blinded observers and correlated with endoscopic and histologic results. Duodenal mucosal-fold thickness was measured on spot radiographs (20% magnification), and the extent of disease was evaluated.

RESULTS: Of 15 children with mild duodenitis, 13 had normal radiologic findings and 11 had normal findings at esophagogastroduodenoscopy. Of nine children with severe duodenitis, all had friability or ulceration at endoscopy and mucosal-fold thickening of greater than or equal to 4 mm (> or = 3 mm in one infant aged less than 1 year) at upper GI examination. Mucosal-fold thickening was diffuse in patients with celiac, autoimmune, and adenovirus disease and was proximal in patients with peptic ulcer and Crohn disease. Of 51 control subjects, 50 had normal radiologic results, while 47 had normal endoscopic results. The sensitivity of upper GI examination for mild and severe duodenitis combined was 46% with a specificity of 98%, whereas endoscopy had a sensitivity of 54% and specificity of 92%.

CONCLUSION: Mucosal-fold thickening was a specific sign of duodenitis in children and should be investigated. Upper GI examination yielded results similar to those at endoscopy.

Volume

206

Issue

1

First Page

103

Last Page

108

ISSN

0033-8419

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

9423658

Department(s)

Department of Pediatrics

Document Type

Article

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