• Advances in pediatric surgery
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• 제8권1호
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• pp.68-70
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• 2002

Enterocolitis associated with Hirschsprung's disease has been a major cause of morbidity and even mortality, and before and after definitieve surgical treatment. It shows typical clinical characteristics, however, its pathogenesis has been poorly understood. Treatment is diverse, and consists of conservative tertment with intravenous hydration, antibiotics and rectal wash out, and surgical tertment with temporatory enterostomy, and other surgical procedures.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권2호
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• pp.127-134
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• 2021

Purpose: In patients with acute enterocolitis, radiologic findings are sometimes accompanied by secondary inflammation of the appendix. The purpose of this study was to evaluate the clinical features of acute enterocolitis with secondary inflammation of the appendix. Methods: Medical records from patients who underwent abdominal ultrasonography or computed tomography (CT) among those admitted for acute enterocolitis were retrospectively reviewed. Clinical features were compared by distinguishing patients with inflammation of the appendix from those without, based on their symptoms and laboratory findings. Results: Of the 165 patients, 12 (7.3%) had secondary inflammation of the appendix on ultrasonography and/or CT. Patients with secondary inflammation of the appendix were significantly older than those without (11.7 vs. 6.1 years, p=0.011) and more frequently had fever (83.3% vs. 49.0%, p=0.033), and high values of C-reactive protein (CRP) (5.38 vs. 0.32 mg/dL, p<0.001). The proportion of bacterial pathogens was higher in patients with secondary inflammation of the appendix (60% vs. 15.1%, p=0.004). Conclusion: Patients with acute enterocolitis accompanied by secondary appendicitis more commonly have fever, higher CRP levels, higher bacterial pathogen detection rates, and longer hospital stays. Treatment equivalent to that of bacterial infection is required for patients with secondary appendicitis, and that their symptoms should be closely and continuously monitored and followed-up.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제4권2호
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• pp.233-237
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• 2001

저자들은 발열, 구토 및 설사를 주소로 내원한 14개월된 여아의 대변배양검사에서 Aeromonas hydrophilia가 배양된 gas forming enterocolitis를 동반한 가와사끼병 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한소아치과학회지
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• 제41권1호
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• pp.80-84
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• 2014

난치성 궤양성 소장결장염은 영아에게서 드물게 나타나는 만성 염증성 장 질환으로 1991년 처음으로 보고되었다. 난치성 궤양성 소장결장염은 주로 영아기에 구강 내 궤양에서 시작되어 항문주위 및 장 질환으로 진행되는 특징을 갖는다. 생후 18일 된 환아가 구강 내 궤양으로 감별할 수 있는 전신질환에 대해 알아보고자 본과로 의뢰 되었다. 당시 구강 내 궤양을 제외한 특이 사항은 없었으며 3주 뒤 혈변이 발생하였다. 대장 내시경 상에서 대장 내 거대 궤양이 발견되었으며 여러검사 결과 난치성 궤양성 소장결장염으로 진단되었다. 치과의사가 난치성 궤양성 소장결장염을 조기에 진단하는 것은 면역 억제제에 반응이 없는 본 질환에 대해 결장절제술을 신속하게 시행함으로써 증상의 완화와 질병의 진행을 막는데 효과적으로 대처할 수 있으므로 매우 중요하다. 또한 대부분의 난치성 궤양성 소장결장염 환아에게서 구강 내 궤양이 가장 먼저 발현되므로 이 질환의 증상과 특징에 대해 아는 것은 매우 의미 있을 것으로 사료되어 보고하는 바이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제4권2호
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• pp.238-242
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• 2001

저자들은 우유 단백질에 대한 FPIES의 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권2호
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• pp.74-79
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• 2014

Food protein-induced enterocolitis syndrome (FPIES) is an under-recognized non-IgE-mediated gastrointestinal food allergy. The diagnosis of FPIES is based on clinical history, sequential symptoms and the timing, after excluding other possible causes. It is definitively diagnosed by an oral food challenge test. Unfortunately, the diagnosis of FPIES is frequently delayed because of non-specific symptoms and insufficient definitive diagnostic biomarkers. FPIES is not well recognized by clinicians; the affected infants are often mismanaged as having viral gastroenteritis, food poisoning, sepsis, or a surgical disease. Familiarity with the clinical features of FPIES and awareness of the indexes of suspicion for FPIES are important to diagnose FPIES. Understanding the recently defined clinical terms and types of FPIES is mandatory to suspect and correctly diagnose FPIES. The aim of this review is to provide a case-driven presentation as a guide of how to recognize the clinical features of FPIES to improve diagnosis and management of patients with FPIES.

• Clinical and Experimental Pediatrics
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• 제60권10호
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• pp.307-311
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• 2017

Necrotizing enterocolitis (NEC) is a devastating condition of hospitalized preterm infants. Numerous studies have attempted to identify the cause of NEC by examining the immunological features associated with pathogenic microorganisms. No single organism has proven responsible for the disease; however, immunological studies are now focused on the microbiome. Recent research has investigated the numerous bacterial species residing in the body and their role in diseases in preterm infants. The timing of initial microbial colonization is a subject of interest. The microbiome appears to transfer from the mother to the newborn, as well as to the fetus. Cross-talk between the fetus and fetal microbiome takes place continuously to generate a unique immune system. This review examined the transfer of the microbiome to the human fetus, and its potential relationship with NEC.

• Clinical and Experimental Pediatrics
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• 제57권12호
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• pp.505-513
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• 2014

While the survival of extremely premature infants with respiratory distress syndrome has increased due to advanced respiratory care in recent years, necrotizing enterocolitis (NEC) remains the leading cause of neonatal mortality and morbidity. NEC is more prevalent in lower gestational age and lower birth weight groups. It is characterized by various degrees of mucosal or transmural necrosis of the intestine. Its exact pathogenesis remains unclear, but prematurity, enteral feeding, bacterial products, and intestinal ischemia have all been shown to cause activation of the inflammatory cascade, which is known as the final common pathway of intestinal injury. Awareness of the risk factors for NEC; practices to reduce the risk, including early trophic feeding with breast milk and following the established feeding guidelines; and administration of probiotics have been shown to reduce the incidence of NEC. Despite advancements in the knowledge and understanding of the pathophysiology of NEC, there is currently no universal prevention measure for this serious and often fatal disease. Therefore, new potential techniques to detect early biomarkers or factors specific to intestinal inflammation, as well as further strategies to prevent the activation of the inflammatory cascade, which is important for disease progression, should be investigated.

• Clinical and Experimental Pediatrics
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• 제54권9호
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• pp.368-372
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• 2011

Necrotizing enterocolitis (NEC) is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birthweight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity. In preterm infants with immature gastrointestinal tracts, development of NEC may be associated with a variety of factors, such as colonization with pathogenic bacteria, secondary ischemia, genetic polymorphisms conferring NEC susceptibility, anemia with red blood cell transfusion, and sensitization to cow milk proteins. To date, a variety of preventive strategies has been accepted or attempted in clinical practice with regard to the pathogenesis of NEC. These strategies include the use of breast feeding, various feeding strategies, probiotics, prebiotics, glutamine and arginine, and lactoferrin. There is substantial evidence for the efficacy of breast feeding and the use of probiotics in infants with birth weights above 1,000 g, and these strategies are commonly used in clinical practice. Other preventive strategies, however, require further research to establish their effect on NEC.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권3호
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• pp.245-255
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• 2021

Necrotizing enterocolitis (NEC) is a disease with high morbidity and mortality that occurs mainly in premature born infants. The pathophysiologic mechanisms indicate that gastrointestinal dysbiosis is a major risk factor. We searched for relevant articles published in PubMed and Google Scholar in the English language up to October 2020. Articles were extracted using subject headings and keywords of interest to the topic. Interesting references in included articles were also considered. Network meta-analysis suggests the preventive efficacy of Bifidobacterium and Lactobacillus spp., but even more for mixtures of Bifidobacterium, Streptococcus, and Bifidobacterium, and Streptococcus spp. However, studies comparing face-to-face different strains are lacking. Moreover, differences in inclusion criteria, dosage strains, and primary outcomes in most trials are major obstacles to providing evidence-based conclusions. Although adverse effects have not been reported in clinical trials, case series of adverse outcomes, mainly septicemia, have been published. Consequently, systematic administration of probiotic bacteria to prevent NEC is still debated in literature. The risk-benefit ratio depends on the incidence of NEC in a neonatal intensive care unit, and evidence has shown that preventive measures excluding probiotic administration can result in a decrease in NEC.