Volume 33, Issue 229 (1-2024)                   J Mazandaran Univ Med Sci 2024, 33(229): 75-80 | Back to browse issues page

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Abstract:   (292 Views)
Background and purpose: Chronic abdominal pain or recurrent abdominal pain is defined as abdominal pain that occurs in at least three episodes, lasting for a minimum of three consecutive months, and is severe enough to adversely affect the child's normal functioning. Abdominal pain can be a challenging complaint for many specialists because, at the same time, it can indicate a completely benign finding, it can also indicate the presence of an acute and malignant pathology. At this stage, the most important action of the treating physician is to diagnose the disease as organic or functional. The present study was conducted to evaluate the diagnostic performance of upper gastrointestinal endoscopy in diagnosing organic causes of chronic abdominal pain in children and investigating the correlation between clinical symptoms and pathological findings of endoscopy in children aged 3 to 12 years with chronic abdominal pain. 
Materials and methods: The present study was conducted as a cross-sectional study on 100 children with chronic abdominal pain without pathological cause who visited the pediatric clinic of Ayatollah Mousavi Hospital in Zanjan, from April to December 2021. At first, after taking the initial history and examining the clinical symptoms of the patient, diagnostic and paraclinical tests were performed to determine the cause of chronic abdominal pain. If the cause of the pain was diagnosed using clinical and paraclinical examinations, the patient was excluded from the study and treated accordingly. Then, the children who could not find a specific cause for their pain were referred to a pediatric gastroenterology specialist for endoscopy. After a complete examination and observation of the upper gastrointestinal tract, a pathology sample was also prepared for all patients, and endoscopic, pathological, demographic, and clinical findings were recorded for all patients. Finally, the data was statistically analyzed by SPSS version 26 software using Chi-2 statistical tests, Fisher's exact test, t-test, and Mann-Whitney.
Results: The mean ± standard deviation of the children's age was 8±2.66 years. 63% of the children were girls and 37% were boys. The most common complaints in children after abdominal pain were vomiting (19%) nausea (14%) and non-response to outpatient treatment (8%). The most common accompanying symptoms besides abdominal pain included nausea, vomiting, tooth decay, and constipation. Endoscopic findings were normal in only two patients with abdominal pain, and in 98% there was at least one organic lesion. The most common findings in pathology examination were GERD I at 48%, Small sliding hiatal hernia at 37%, and GERD II at 24% respectively.
Conclusion: Our findings indicated that most cases of chronic abdominal pain in children had an organic origin, and it was better to conduct further investigations to identify the cause of the pain. The most common pathological findings in these children were GERD I, II, and sliding hiatal hernia. Clinical manifestations of the disease, diverse clinical symptoms, paraclinical findings, initial tests, and mucosal biopsy results can help diagnose the cause of chronic pain. By finding the cause of the pain, effective actions can be taken to control the pain of these children
Type of Study: Brief Report | Subject: children

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