Gastroenterology utrition Abstracts

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 Gastroenterology & utrition Abstracts

   Characterization of Lactobacillus                      Iron Supplement Compliance in Iranian
 plantarum A7 as potentially probiotic                   Infants, Experience from Hamadan, West
       strain for Iranian infants                                         of Iran
Maryam Mirlohi, Isfahan University of technology,       Firouzeh Hosseini, M.D. Assistant Professo of
PhD student of food science and technology and          Pediatric-Mohammad Mehdi Fazlian, M.D. General
tutor of school of health and nutrition in Isfahan      Practitioner, Emergency Department, Besat Hospital,
University of medical science                           Hamadan University of Medical Sciences

Gastrointestinal infections leading to diarrheal        Objective: For paucity of data about the leading cause
disease still are one of the most important causes of   for discontinuation or disobedience of iron supplements
children's hospitalization and death in developing      regimes, this study was carried out to investigate the
countries especially in rural arias. This study aimed   compliance of parents in supplementing iron-containing
at elaborates a native probiotic strain with anti       medications to their infants.
pathogenic effects to use in clinical studies among     Methods: In a cross-sectional prospective study
Iranian children. A Lactobacillus plantarum strain      between January and November 2005 in Hamadan,
was selected out of 33 isolates of lactobacilli         Iran, 320 infants aged 6–24 month and visited in
originated from fecal flora of eleven healthy           hospital clinics were included. A questionnaire
children, under two years of age due to it's superior   designed with a set of equations about the iron
tolerance to acid and bile, raveled by growth and       supplementation and filled by the attendance. Exclusion
survival studies.This strain was isolated at the        criteria were having a chronic medical condition, major
population of 5.96 CFUg-1 of fecal material of 19 -     thalassemia, hemochromatosis or congenital disorders.
month old infant and identified by biochemical and      Results: From the 320 samples studied the
molecular methods and called as L. plantarum            questionnaire of 313 children (161 (51.4%) male and
A7.The gastric transit tolerance of examined strain     152 (48.6%) female were analyzed. seven
was further challenged against a commercial             questionnaires were excluded according to exclusion
probiotic strain through artificial gastric and         criteria. The mean for age and weight were 14.03±5.27
intestinal juice which resulted in comparative          month and 9.31±1.66 Kg respectively. 226 (72.2%) of
resistance with a commercial strain, displaying         parents used iron supplement and 87 (27.8%) didn’t
nearly 90% survival under the tested condition. For     continue or use it at all. there is no difference between
antimicrobial activity, the cell free culture           demographic values of these groups. The main reasons
supernatant (CFCS) of the examined strain was           for disobedience of iron supplement were failure of
tested using well diffusion method against              toleration (53.27%), occurs of complication include
pathogenic microorganisms. Escherichia coli PTCC        dental discoloration, constipation or diarrhea (25.23%),
1270, Salmonella choleraesuis subsp. cholerasuis        health system delivery failure (13.08%) and weakness
serotype typhimurium PTCC1622, Shigella                 of knowledge and information about its benefits
dysentery PTCC1188, clinical isolates of Listeria       (8.41%).
monocytogenes RITCC 1293 and Escherichia coli           Conclusion: the finding of this study mentioned that a
RITCC1293, clinical isolates of Kelbsiella              considerable proportion of infants didn’t receive
pneumoniae obtained from medical University of          adequate amount of iron supplements so the attempt
Isfahan and a clinical isolates of Serratia             attention and intervention should be paid for it
marcessense PTCC1184 were included in the study         improvement.
as indicator strains. All the pathogenic bacteria       Keywords: Iron Deficiency Anemia, Compliance, Iron,
were more or less inhibited by the CFCS of L.           Infants, Iran
plantarum A7, Listeria monocytogenes and
Shigella dysentery were shown to be the least and          Coexistence of celiac disease and cystic
most sensitive strains in two replicates of three
individual tests. In conclusion, the examined strain                fibrosis in children
could be characterized as a potentially probiotic
regarding the resistance to gastrointestinal            Shohreh Maleknejad MD, Pediatric Gastroenterologist,
condition and antipathogenic activity. Its origin       Guilan University Medical Sciences
may imply a safe background, which is the
prerequisite of each bacterial strain candidates for    Objective: Celiac disease (CD) is a genetic disorder
probiotic use.                                          affecting children and adults that patients with celiac
Keywords: Probiotic, GI infection, Iraninan infants     disease are unable to eat foods that contain gluten,
                                                        witch in found in wheat and other grains, in people with
                                                     Proceeding of the 20th International Congress of Pediatrics; Oct 2008
14                                                                                             Gastroentrology Abstracts

     celiac disease, gluten sets off and autoimmune            malabsorption and malnutrition. Therefore the Co-
     reaction that causes the destruction of the villi in      existence of these disorders can easily be missed in
     the intestine. Clinical features of CD differ             patients with CD who continue to have FTT, diarrhea,
     considerably most depending on the age at                 despite appropriated caloric intake and a gluten free
     presentation. Intestinal symptoms are common in           diet, a search for coexisting pathologic conditions in
     children diagnosed within the first 2 years of life.      necessary.
     Failure to Thrive, Chronic diarrhea, abdominal            Keywords: Celiac disease, Cystic fibrosis, Children
     distention, muscle wasting, anorexia, and
     irritability are often present. Celiac disease             Evaluation of H. pylor erradication effect
     presentation later in childhood are characterized by
     the prevalence of extraintestinal symptoms,                on patients with refractory iron deficiency
     manifesting with minor abdominal symptoms, short                anemia in outpatient children of
     stature, delayed puberty, anemia, and joint                 gastroentrology clinic of imam khomini
     complaints. A number of disorders have been                                  hospital
     described in association with celiac disease. Some
     disease with an autoimmune pathogenesis are
     found with a higher than normal frequency in celiac       Shahla Bahremand MD, Amir abbas vaezi MD
     patients consist Insulin- dependent diabetes              Tehran University Science
     mellitus, Thyroiditis, chronic active hepatitis,
     chronic fibrosing alveolitis, Sjögren's syndrome,         Introduction: Iron deficiency anemia is the most
     IgA nephropathy, Cow's Milk sensitive entropathy,         common anemia worldwide,and helicobacter pylori is
     Addison's disease. An increased incidence of Down         the most common pathogenic organism that infected
     syndrome has been found in CD patients compared           human being. The outcome of chronic H pylori
     with the general population. Selective IgA                infection varies from asymptomatic gastritis to peptic
     deficiency is also a condition associated with celiac     ulceration and gastric malignancies.helicobacter pylori
     disease. Finally, there are reports of associations       has      recently     been      linked     to      several
     between CD and other disease of the                       extragastricdisorders,Several clinical reports have
     gastrointestinal tract, such as cystic fibrosis,          demonstrated that Helicobacter pylori gastric infection
     Dermatitis herpetiformis.                                 has emerged as a new cause of refractory iron
     Case report: An 13- year – old boy was evaluated          deficiency anemia, unresponsive to iron therapy, and
     at a routine visit he was noted to have poor weight       not attributable to usual causes such as intestinal losses
     gain (height and weight below 5th percentile), with       or poor intake, malabsorption or diversion of iron in the
     frequent, bulky stools. Her parents were                  reticuloendothelial system. In this study we tried to
     consanguineous, other daughter patient have               evaluate the effect of H.pylori eradication on children
     diabetes mellitus that received insulin Therapy. In       with refractory Iron deficiency anemia and H.pylori
     follow up evaluation Anti- gliadin and anti-              infection.
     endomysial antibodies were both positive. The             Methods: 32 children with refractory Iron deficiency
     patient underwent an esophagogastroduodenoscopy           anemia whom were reffered to pediatric.G.I outpatient
     with biopsies, which related complete villous             clinic of Tehran Emam Khomeini Hospital have been
     flattening in the duodenum, the lamina propria            studied and underwent G.I endoscopy, we found
     contained an increased number of inflammatory             H.pylori in gastric biopsies of all of them,we eradicate
     cells in association with lymphocytosis in the            their H.Pylori with triple drug regimen and we conferm
     surface epithelium. A diagnosis of celiac disease         the eradication with UBT. 6 months after H. pylori
     was made and a gluten – free diet was instituted. In      eradication we reevaluate the hematologic indices and
     follow up the number of defecation decreased and          Iron restores Coparing with previous indices. Results: 6
     patient had weight gain but after one year in follow      month after confirmed h. pylori eradication in 89% of
     up again the number of defecation increased. That         patient the Hg mean increased from 9.9±0.97 to
     in according to chronic cough and pansinusitis            12.09±0.57, ferritin mean increased from 7.2±0.36 to
     stool exam performed that stool exam showed low           33±10.4,serum iron mean increased from 18±3.8to
     fecal trypsin activity and in sudan stain                 55±4.8,iron sat index mean increased from 6.6±1.3 to
     examination the number of fat droplet was                 23±8.3, MVC mean increased from 73± 3.1to 81±2.7
     abundant. Sweat test was performed twice that             RBC mean increased from 4±0.3 to 5.1±0.1.
     results of sweat tests were positive. The patient         Conclusion: 6month after confirmed h.pylori
     with diagnosis of cystic fibrosis received pancreatin     eradication, Iron deficiency anemia of 28 patient (89%)
     and supplement and Gluten free diet. Conclusion:          reversed,and their hemoglobin, ferritin, seruiron, iron
     The coexistence of celiac disease and CF have been        saturation index,Mcv,RBC significantly increased.
     reported previously in multiple case reports.             Keywords: Refractory iron deficiency Anemia,
     Although the pathogenesis of CF and celiac disease        Helicobacter pylori, Children.
     are clearly distinct, the clinical features of the two
     disease are similar especially when manifested by
Proceeding of the 20th International Congress of Pediatrics; Oct 2008                                                     15
Gastroentrology Abstracts

      Study of possible association of                     mucosal colonization. It introduces local and systemic
      Helicobacter pylori and giardia                      immune mechanisms leading to inflammation,
                                                           ulceration and even malignant changes. Helicobacter
           infection in children                           pylori infection is acquired in childhood mostly via
                                                           fecal – oral and gastric – oral routes. Gold standard test
Maryam Monajemzadeh, MD, Assistant professor               for H. pylori diagnosis is pathology. Non– invasive
in pathology; Mohammad Taghi Haghi Ashtiani,               diagnostic tests have different sensitivities, specificities
MD, Associate professor in pathology; Afshin               and accuracies.
Mahjarali, MD, Resident of pathology                       Materials & Methods: Fifty children with documented
                                                           Helicobacter pylori infection (positive pathology)
Background: Helicobacter pylori is one of the              enrolled the study and were compared with fifty age
most important pathogens of gastrointestinal tract.        matched children negative for H.pylori. Both groups
The     mechanisms      of    Helicobacter     pylori      had been scheduled for upper gastrointestinal
transmission are not understood completely but             endoscopy in Children Medical center in Iran from
fecal-oral routs seem to have a possible role in its       2001 to 2003 because of peptic disease complaints.
transmission. On the other hand giardia lamblia            Helicobacter pylori serology (IgG by ELISA method)
commonly causes diarrhea especially in children            and rapid urease tests ere compared between two
and infection of a host is initiated through direct        groups. T- test and chi- square were done and SPSS-13
fecal-oral contact. As the routs of infection seem         was used for data analysis.
common in these two organisms, we decided to               Results: There was no significant difference in average
examine the frequency and the relationship of              age between two groups (p=0.787). Serology had 30%
helicobacter pylori and giardia infection in children      sensitivity, 88% specificity, 71.4% positive predictive
with abdominal pain to investigate whether the             value and 55.7% negative predictive value. For rapid
infections caused by these two organisms are               urease test, these were 84%, 88%, 87.5% and 84.6%
associated with each other or not. Method: Stool           respectively.
samples of 42 consecutively admitted children with         Conclusion: An ideal and appropriate non-invasive test
presence of giardia organism in their stool and 42         must have low cost, easy availability, high sensitivity,
healthy children as control group were investigated        specificity and accuracy.It is almost impossible for
for presence of Helicobacter pylori antigen by Elisa       Helicobacter pylori non-invasive tests to have all of
method in parasitology lab, children medical center        these characteristics together.Amongst diagnostic
hospital, Tehran, Iran over a 6-month period.              methods of H. pylori infection, it seems that in children;
Demographic data and information about life style          rapid urease test (as an invasive method) has better
of family members were also gathered. Results:             results than IgG serology.
among 42 children with giardia infection,                  Keywords: Helicobacter pylori, Children, Serology -
17(40.5%) were also had Helicobacter pylori                urease
infection according to stool antigen test for this
organism. In healthy controls (without giardia
infection), there were 6 cases (14.3%) with h pylori        Celiac disease in Denmark: prevalence and
infection (p<0.007) Conclusion: our data support             age distribution at diagnosis 1995-2005
the theory that Helicobacter pylori infection, like
giardias, is associated with surrogate marker of           P. Toftedal1, D. G. Hansen2, C. ielsen3, S. T.
fecal exposure and the transmission of them may be         Lillevang3, S. Husby1
the same, so sanitation may cause to reduce the rate         Department of Paediatrics, Odense University
of both infections.                                        Hospital, 2Research Unit for General Practice Odense,
Keywords: Helicobacter pylori, Abdominal pain,             University of Southern Denmark, 3Department of
Giardia,                                                   Clinical Immunology, Odense University Hospital,
                                                           Odense, Denmark
 Comparative study for assessing value
                                                           Introduction: Overt coeliac disease in children and
  of serology versus rapid urease test in                  adolescents has been diagnosed with a very low (0.2‰)
 childhood Helicobacter pylori infection                   prevalence in Denmark (Weile et al. 1993) compared to
                                                           neighbouring countries in Europe. The reason for this
Bahar Allahverdi Assistant prof., LUMS -                   discrepancy is unclear in particular as a high prevalence
Gholamreza Khatami Professor, TUMS - Mahmood               of coeliac disease (12 %)            has recently been
Ahmadi, Professor, TUMS - Amin Ghorbani                    demonstrated in Danish children with type 1 diabetes
Vaghei, Infectious Diseases Resident, ZUMS -               (Hansen et al. 2006).
Saeed Foroughi, MSc in nursing, LUMS                       Methods: The aim of the present study was to estimate
                                                           the prevalence of coeliac disease in Danish children and
Backgrounds: Helicobacter pylori is a gram                 adolescents between 0 and 18 years of age during a 10
negative, flagellated microbe with demonstrable            year period from 1995. Data on patients diagnosed with
ability of penetrating gastric mucus layer and             coeliac disease were obtained from the Danish National
                                                    Proceeding of the 20th International Congress of Pediatrics; Oct 2008
16                                                                                            Gastroentrology Abstracts

     Registry for Patient Diagnosis. Since 1977 this          day to tir (recent 7 months). we designed a
     registry has provided a high quality national            questionnaire in the Text book of pediatric
     hospital discharge registry with a positive              gastroenterology (wyllie). We evaluated 200 samples
     predictive value of approximately 95%.                   by filling out the dsigned questionnaires. All the
     Results:     The     registered    prevalence    was     information were processed in spss software and tested
     approximately 0.7 ‰ in the period 1995-2005 with         by in chi-square an fisher exact test.
     a minor decrease from 2003 to 2005 (0.6‰). The           Results: 107 boys (53.5%) and 93 girls (46.5%) were
     peak age of diagnosis was 2-3 years of age. Above        taken part in our study the avarage age was 4.2+-1.8
     this age the number of patients diagnosed with           years (rangers 2-7). All of them suffered from chronic
     coeliac disease decreased steadily by increasing         cogh who were seeking fore medical attention.GER
     age. The distribution of age at time of diagnosis did    detected in 21.9% of children with episodic day and
     not change over the observation period.                  night cough and 16.5% of children with episoic night
     Conclusion: The prevalence of coeliac disease in         coygh. Wheeing, light sleep, were the most common
     children is stable at 0.7‰ during the period of          sign of GER (41%) and then food refusing with the
     study. Thus, the present study shows a three-fold        incidnce of 40.5% was secon sign of GER.
     increase in prevalence from 1980’es to the last          Conclusion: Genereal incidence of GER was 7%.we
     decade, still at a low level compared to                 concluded that incidence of GER in 2-7 year old
     neighbouring countries. The majority of children         children complaied from chronic cough was between
     were diagnosed at 2-3 years of age. However, non-        3.5-10.5 %.there as not any significant relationship
     classical coeliac disease may be underdiagnosed in       between GER and sex (p.value~0.408) and age
     Denmark.                                                 (p.value~0.295). yhis study showed that GER
     References: Weile B, Krasilnikoff PA. J Clin             prevalence is significantly higher in patient who
     Epidemiol. 1993 Jul;46(7):661-4. Hansen D et al.         suffered from night cough (p.value~0.000).
     Diabetes Care. 2006, 11: 2452-6.                         Keywords: GER. Chronic cough, Reflux

     Identifying GER incicence as a cause of                   Study of correlation between Helicobacter
     chronic cough in 2-7 years old children                    pylori infection and halitosis in children
                    in yazd                                   Farid Imanzadeh,       Associate    Prof.   of   Pediatric
     Hossein ali azemian MD, Pediatrition, Social
     Security Hospital, Shohadaye Kargar Hospital/            Introduction and aim: Halitosis or bad breath is one of
     Mehrdad Mirvakili MD Medical Student, Ali ebn            the problem that causes the child was visited by
     abitaleb University                                      physician. Halitosis had several causes. Infection with
                                                              H.pylori is one of the possible causes of halitosis. The
     Introduction: Fortunatly in these recent 3 decades       aim of this study was the evaluation of association
     the rate of gastric cancer and duodenal ulcer and        between helicobacter pylori infection with halitosis.
     related to their complication has decreased. but         Methods and Materials:his cross sectional study was
     GERD and Esophageal Adenocarcinoma as a major            carried out in Mofid Children’s Hospital. Patients who
     problem due to GERD has decreased definitely.            had halitosis as the main chief complaint visited in the
     GER occurs in about 9-5% in children and 4-5%in          outpatients clinic and without manifestations of liver
     adult and because of new life style,it is increasing.    disease, dental infection, fever, failure to thrive were
     there is not any golden standard test for confirming     included in our study. UBT was done for all cases( with
     the GER diagnosis and in the other hand leaving          halitosis) and all of the control(without halitosis)
     GER with out treatment can induce esophagitis in         subjects. 33 cases and 67 control subjects were included
     2% of these people and adenocarcinoma in ages            in our study. Results: From cases, 7 cases had H.pylori
     between 30-50 early diagnosis and Treatment can          infection. From control subjects, 18 had helicobacter
     prevent these major complications, purpose:main          pylori infection. There is no significant difference
     Purpose: Identifying GER incidence as a cause of         between case and control groups(P>0.05). Halitosis
     chronic cough in 2_7 years children who referred to      patients were dividing in two group regarding H.pylori
     social security organization clincis. special            infection. Early satiety, anorexia, and heartburn were
     purpose: 1.GER incidence in our subjects based on        compared in two groups. 19 cases had early satiety and
     their age 2.GER incidence in our subjects based on       3 of them had H.pylori infection. 12 cases had not early
     their sex 3.GER incidence in our subjects based on       satiety and 3 of them had H.pylori infection. Significant
     their the Type of cough.                                 difference was not found( P>0.05). Anorexia was seen
     Methods: this study is a descriptive case series in      in 18 cases with 3 of them had H.pylori infection. 12
     which diagnosis of GER is based on history taking.       cases did not have anorexia and 3 of them had H.pylori
     Our subjects were 2_7 years old children who             infection. Significant difference was not found
     refferrd     to   social    security    organization     (P>0.05). Heart burn was seen in 4 cases (1 H.pylori
     clinics,because of chronic cough (>=2 weeks) from        positive), and 27 cases without heartburn (5 cases had
Proceeding of the 20th International Congress of Pediatrics; Oct 2008                                                   17
Gastroentrology Abstracts

H.pylori infection). Conclusion: Our study did not         supplementation on diarrhea duration and severity
show significant difference of H.pylori infection          among children aged <5 y.
between halitosis group and without halitosis. In          Methods: This study was a double –blind, randomized,
halitosis patients, there are no significant               placebo controlled trial. Children (228 subjects) who
differences for H.pylori infection for patients with       hospitalized with an acute diarrhea were randomly
heartburn, anorexia, satiety and patients without          assigned to receive 20 mg Zn or placebo for the
them. Another prospective study in children is             duration of illness.
recommended.                                               Results: Findings showed that the severity of diarrhea
Keywords:Halitosis, Helicobacter pylori, infection         in supplemented children (75% > 3 times/d) was less
                                                           than placebo group (90% >3 times/d). No significant
                                                           difference was found on the duration of diarrhea
        Screening by anti-tissue                           between two groups.
  transglutaminas antibodies for celiac                    Conclusion:       Our   data    indicate    that    zinc
   disease in diabetic children in Iran                    supplementation reduces the severity of acute diarrhea.
                                                           Keywords: Zinc, Diarrhea, Children
Gholamhossein Fallahi, MD; JH Ahmadian, MD;
Ali Rabbani, MD; Asadollah Rajab, MD; Dept of              Pediatric Pancreatitis Etiology and Imaging
Pediatric Gastroenterology, Children’s Medical
Center, Medical Sciences/University of Tehran,
IR.Iran; Azadeh Yoosefnejad, MD, Immonology,
                                                           M Mearadji- MD International            Foundation    for
Athma & Allergy Research Institue, Medical
                                                           Pediatric Imaging Aid
Science, University of Tehran, IR. Iran
                                                           Progress in clinical research and imaging technology
Background: The aim of this study was to
                                                           contributed largely in diagnosis of pancreatitis. Because
determine the minimum prevalence of coeliac
                                                           of the complex function of the pancreas on one hand
disease in a group of 96 Iranian diabetic children.
                                                           and the diversity of etiology of pancreatitis on the other
Methods: A total of 96 patients with type 1
                                                           hand, clinical and diagnostic approach by experienced
diabetes mellitus aged 1-18 years and with age at
                                                           clinicians is necessary in children with chronic or acute
onset at 1 month to 12 years reffered to diabetic
                                                           pancreatitis. The incidence of acute and chronic
center of Tehran,Iran agreed to participate in the
                                                           pancreatitis is unknown. Both are associated with
study. All patients were tested for anti-tissue
                                                           significant morbidity and mortality. Patients with non-
transglutaminas antibodies with AESCULISA
                                                           traumatic acute pancreatitis present with abdominal
kit.Intestinal biopsy were done for patients with
                                                           pain, nausea and vomiting. Elevation of serum
seropositive sample.
                                                           concentration of pancreatic enzymes is common.
Results: Six patients were had seropositive test. All
                                                           Chronic pancreatitis in children is less common than
of them had histopathological change for celiac.
                                                           acute pancreatitis and can be found incidentally in
Conclusion: In this first celiac disease prevalence
                                                           association with other entities such as cystic fibrosis. A
in Iranian diabetic children, specifically with
                                                           large number of etiological factors and conditions is
measuring          Anti-tissue       transglutaminas
                                                           associated with childhood pancreatitis. Up to now 80
antibodies,we found a high prevalence (6.25%) in
                                                           different etiological considerations are reported.
diabetic population of Iranian children.
                                                           Physical injury is one of the most commonly described
Keywords: Prevalence, Celiac disease, Type 1
                                                           causes of pediatric pancreatitis (22%-41%) followed by
                                                           biliary obstruction. Other etiological factors of acute or
                                                           chronic pancreatitis include drugs, hereditary and
    Impact of zinc supplementation on                      metabolic diseases as well as viral infection. Diagnostic
     diarrhea duration and severity in                     imaging of such conditions should not be limited to
      hospitalized children in Ardebil                     pancreatitis alone but should also focus on detection of
                                                           etiological factors. Diagnostic imaging: Plain film
                                                           radiography has limited value in the evaluation of
Afrouz Mardi; Dr Barak Manouchehr; Mehrnaz
                                                           pancreatic anatomy and pathology. Occasionally
Mashoufi; Mahnaz Azari; Dr Asghar Abdolahi
                                                           abnormal calcification, bowel displacement and other
Ardebil university of medical sciences
                                                           intestinal changes may be indirect signs of pancreatic
                                                           disease. Sonography is an initial procedure for the
Background: Recent studies reported that zinc
                                                           evaluation of pancreatitis. The edema that accompanies
significantly reduced duration and severity of acute
                                                           pancreatitis often results in a hypo-echoic diffusely
diarrhea in children. Zinc deficiency is prevalent in
                                                           enlarged gland with or without pancreatic duct
children in developing countries. Supplemental
                                                           dilatation. Pancreatic pseudo-cysts can be recognized.
zinc provides therapeutic benefits in diarrhea. Our
                                                           Fluid collections as ascites and pathological changes of
aim was to evaluate the effect of zinc
                                                           the biliary tract are some other findings of pancreatitis.
                                                           CT is an adequate modality in imaging of pancreatic
                                                    Proceeding of the 20th International Congress of Pediatrics; Oct 2008
18                                                                                            Gastroentrology Abstracts

     pathology. Swelling, ductal dilatation, hemorrhage       based on our own experience and review of literature. A
     and phlegmonas are more clearly visible as well as       retrospective study of 25 selected cases with different
     cystic changes. Magnetic Resonance Cholangio-            etiologies will be discussed.
     Pancreatography (MRCP) has become a useful and
     non-invasive diagnostic modality for evaluation of         Effect of probiotics on H-P treatment in
     biliary and pancreatic conditions, as a non-invasive                       children
     procedure with equivalent results as the more
     invasive technique by Endoscopic Retrograde              Enayatollah         Khoradsani,         Gastroentrologist,
     Cholangio-Pancreatography (ERCP). Indication for         Kermanshah
     ERCP is limited to exceptional complicated cases
     of recurrent pancreatitis, but should not be used in     The probiatics are alive microorganisms that support
     the acute phase of pancreatitis. The use of ERCP is      healty in humans. Usfule of them todays about any
     indicated mostly as a therapeutic technique to           problems for examples: rota virous diarrhea, IBD(
     remove biliary stones or in placement of a stent         crohn disease), atopic diseases and ect. According to
     with stenosis of the biliary tract. This presentation    the new researchs on them, uses for trentment of Helico
     will focus on imaging findings, diagnostic               bacter pylori. For add on therapy.
     approaches, and etiologies in pediatric pancreatitis,    Keywords: Hilcobacter Pylori-Probioutic

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