• Clinical and Experimental Pediatrics
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• v.53 no.1
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• pp.89-92
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• 2010

Perianastomotic ulceration (PAU) rarely occurs after small bowel resection in infancy. Since the understanding of its pathogenesis is incomplete, an effective method of treatment has not yet been discovered. We report the first case in Korea of a 10-year-old girl with chronic iron deficiency anemia (IDA) and growth failure who was diagnosed with PAU at colonoscopy. Seven years were required to identify the cause of IDA. After surgical resection and revision of anastomosis, a close follow-up is being conducted due to the risk of recurrence. Here, we also review reports on 25 pediatric patients with PAU derived from a search of the English-language literature and describe the clinical features of PAU along with the results of treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.138-146
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• 2007

Purpose: Ischemic enterocolitis (IEC) is the total or partial infarction of the intestine in the absence of occlusion of a major mesenteric blood vessel. The purpose of this study was to evaluate the clinical features of IEC in children. Methods: A clinical analysis of 6 patients with IEC who were admitted to the Department of Pediatrics at Pusan National University Hospital, between 1996 and 2005 was conducted retrospectively. Patients were diagnosed with IEC based on clinical characteristics, including radiologic, endoscopic, histopathologic, and intraoperative findings. Results: Four boys and 2 girls between the age of 6 weeks and 6 years were included in this study. Most of the patients were born at term and had a birth weight that was appropriate for their gestational age. The major symptoms of IEC observed included hematochezia or hematemesis (5 cases), vomiting, diarrhea, abdominal pain or irritability (4 cases), as well as abdominal distension and fever (3 cases). IEC occurred in thecolon in 5 cases (2 descending colon, 1 descending and sigmoid colon, 1 sigmoid colon, 1 whole colon) and the duodenal bulb and gastric antrum in 1 case each. The type of the lesions observed includedulcera, which were found in 3 cases, perforation, which was pbserved in 2 cases, necrotic patches, which were observed in 2 cases, stricture, which was observedin 1 cases, and massive membranous desquamation of the epithelium, which was observed in 1 case. Two of the patients received surgical treatment and the remaining four were treated conservatively. None of the patients died. Conclusion: The presentation of IEC varies, and the findings of this study will be helpful in managing patients with IEC.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.10-15
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• 2009

Purpose: The manner of rectal bleeding of auto-amputated polyps (AP) is similar to juvenile polyps (JP) or Meckel's diverticula (MD). We conducted this study to characterize the clinical spectrum of AP. Methods: Fourteen patients were enrolled this study who were diagnosed AP due to painless rectal bleeding. The clinical data of AP was assessed and then compared with the clinical data of JP and MD retrospectively. Results: The prevalence of AP was 10.4% (14/135) and high in younger patients compared with that of JP (p=0.042 below 2 years). Whereas JP was more common in patients aged 2 to 5 years (p=0.005). Male was predominant in AP (p=0.008 AP vs JP). The manner of rectal bleeding in AP group was sudden and transient. There was no significant difference in time interval between onset of rectal bleeding and diagnosis between the 3 groups. However AP was diagnosed in 9 patients (64.3%) within 7 days after onset of rectal bleeding, but JP was diagnosed in 5 patients (4.1%) in the same period (p<0.001). All of AP were located in the rectum and the sigmoid colon. The mean hemoglobin was 11.3${\pm}$1.5 g/dL in AP, 11.8${\pm}$1.3 g/dL in JP, and 8.4${\pm}$1.2 g/dL in MD (p<0.001, only significant in MD). Conclusion: AP may be considered in male older than 1 year with transient and sudden onset or increase of painless rectal bleeding without drop of hemoglobin level.