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Abstract. This is a retrospective study of upper gastrointestinal hemorrhage in 68 children and adolescents who were less than 19 years old. In descending order of frequency, the five most common causes were duodenal ulcers, gastric ulcers, esophagitis, gastritis, and esophageal varices. There was male predominance in all diagnoses except gastric ulcers and gastritis. Signs and symptoms correlated poorly with the source of bleeding. Endoscopy was the most reliable method of identifying the bleeding site. Mortality correlated with the following: (1) initial hematocrit or hemoglobin level of <20% or <7 gm/100 ml, respectively, (2) transfusion requirements of >85 ml/kg of blood without surgical intervention, (3) failure to identify the source of bleeding, (4) presence of a coagulation disorder, and (5) coexistence of another life-threatening disease. Pediatrics 63:408-413, 1979, bleeding, hemorrhage, gastrointestinal. [ABSTRACT FROM AUTHOR] more...

ABSTRACT. The esophageal intraluminal pH probe test (Tuttle test) was used in 24 pediatric-age patients who had symptoms of gastroesophageal (GE) reflux to determine its sensitivity in detecting gastric acid reflux and to document its usefulness as a prognostic indicator. Eight children had a positive Tuttle test. Six of these patients failed a trial of medical management and required surgery to control their symptoms. None of these patients had GE reflux on esophagrams, Only one of 16 children with a negative test required surgery. This patient also did not have GE reflux on esophagram. The Tuttle test should be included in the diagnostic evaluation of pediatric patients with the clinical presentation of GE reflux. INSET: SCIENTIFIC LITERATURE. [ABSTRACT FROM AUTHOR] more...

Abstract. Fifteen infants with symptoms of gastroesophageal reflux (GER) were evaluated with esophageal manometric studies. Six infants failed on a medical regimen of frequent thickened feedings and an upright position 24 hours per day for three weeks. These infants had Nissen fundoplications. Their mean lower esophageal sphincter (LES) pressure was 12.7 mm Hg. The nine infants who did well on the medical regimen had a mean LES pressure of 19.6 mm Hg. These means are significantly different (P < .001). Esophageal manometric studies should be included in the evaluation of all infants with symptoms of chronic GER. Pediatrics, 59:58-61, 1977, ESOPHAGUS, MANOMETRY, GASTROESOPHAGEAL REFLUX. [ABSTRACT FROM AUTHOR] more...

Abstract. Accidentally swallowed foreign bodies were removed from the esophagus or stomach in six children using flexible panendoscopes. Complications did not occur. The increased flexibility of these new instruments allows removal of objects from the stomach that would previously have required gastrotomy. Our experience suggests that fiberoptic endoscopy should be used for removal of foreign bodies. Pediatrics, 57:931-934, 1976, FOREIGN BODY, FLEXIBLE FIBEROPTIC ENDOSCOPE. [ABSTRACT FROM AUTHOR] more...