The Importance of Esophageal and Gastric Diseases as Causes of Chest Pain
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Pediatric chest pain is considered to be idiopathic or caused by benign diseases. This study was to find out how much upper gastrointestinal (UGI) diseases are major causes of chest pain in pediatric patients.Methods: The records of 75 children (42 boys and 33 girls, aged 3-17 years old) who have presented with mainly chest pain from January 1995 to March 2015 were retrospectively reviewed. Chest X-ray and electrocardiography (ECG) were performed in all aptients. Further cardiologic and gastrointestinal (GI) evaluations were performed in indicated patients.Results: Chest pain was most common in the children of 6 and 9 to 14 years old. Esopha-gogastric diseases were unexpectedly the most common direct causes of the chest pain, the next are idiopathic, cardiac diseases, chest trauma, respiratory disease, and psychosomatic disease. Even though 21 showed abnormal ECG findings and 7 showed abnormalities on echocardiography, cardiac diseases were determined to be the direct causes only in 9. UGI endoscopy was performed in 57 cases, and esophago-gastric diseases which thereafter were thought to be causative diseases were 48 cases. The mean age of the children with esophago-gastric diseases were different with marginal significance from that of the other children with chest pain not related with esophago-gastric diseases. All the 48 children diagnosed with treated with GI medicines based on the diagnosis, and 37 cases (77.1%) sub-sequently showed clinical improvement. Conclusion: Diagnostic approaches to find out esophageal and gastric diseases in children with chest pain are im-portant as well as cardiac and respiratory investigations.
Abstract
Purpose: Pediatric chest pain is considered to be idiopathic or caused by benign diseases. This study was to find out how much upper gastrointestinal (UGI) diseases are major causes of chest pain in pediatric patients.Methods: The records of 75 children (42 boys and 33 girls, aged 3-17 years old) who have presented with mainly chest pain from January 1995 to March 2015 were retrospectively reviewed. Chest X-ray and electrocardiography (ECG) were performed in all aptients. Further cardiologic and gastrointestinal (GI) evaluations were performed in indicated patients.Results: Chest pain was most common in the children of 6 and 9 to 14 years old. Esopha-gogastric diseases were unexpectedly the most common direct causes of the chest pain, the next are idiopathic, cardiac diseases, chest trauma, respiratory disease, and psychosomatic disease. Even though 21 showed abnormal ECG findings and 7 showed abnormalities on echocardiography, cardiac diseases were determined to be the direct causes only in 9. UGI endoscopy was performed in 57 cases, and esophago-gastric diseases which thereafter were thought to be causative diseases were 48 cases. The mean age of the children with esophago-gastric diseases were different with marginal significance from that of the other children with chest pain not related with esophago-gastric diseases. All the 48 children diagnosed with treated with GI medicines based on the diagnosis, and 37 cases (77.1%) sub-sequently showed clinical improvement. Conclusion: Diagnostic approaches to find out esophageal and gastric diseases in children with chest pain are im-portant as well as cardiac and respiratory investigations.
참고문헌 (26)
- Driscoll DJ, "Chest pain in children:a prospective study", Pediatrics, 57, pp.648~651 (1976)
- Fyfe DA, "Chest pain in pediatric patients presenting to a cardiac clinic", Clin Pediatr (Phila), 23, pp.321~324 (1984)
- Pantell RH, "Adolescent chest pain: a prospective study", Pediatrics, 71, pp.881~887 (1983)
- Bernstein D, "Nelson textbook of pediatrics", pp.2163~2170 (2015), Elsevier Saunders
- 윤경림, "소아 청소년기의 흉통", 대한의사협회지, 53(5), pp.407~414 (2010), 대한의사협회
- Sabri MR, "Chest pain in children and adolescents: epigastric tenderness as a guide to reduce unnecessary work-up", Pediatr Cardiol, 24, pp.3~5 (2003)
- Kyung Mi Jang, "Changing Prevalence of Helicobacter pylori Infections in Korean Children with Recurrent Abdominal Pain", Pediatric Gastroenterology, Hepatology & Nutrition, 18(1), pp.10~16 (2015), 대한소아소화기영양학회
- Asnes RS, "Psychogenic chest pain in children", Clin Pediatr (Phila), 20, pp.788~791 (1981)
- Raiola G, "Chest pain in adolescents", Minerva Pediatr, 54, pp.623~630 (2002)
- Selbst SM, "Chest pain in children", Pediatrics, 75, pp.1068~1070 (1985)
- Swenson JM, "Are chest radiographs and electrocardiograms still valuable in evaluating new pediatric patients with heart murmurs or chest pain?", Pediatrics, 99, pp.1~3 (1997)
- Kim JH, "Clinical study of chest pain in children.", J Korean Pediatr Soc, 33, pp.1526~1532 (1990)
- Leung AK, "Chest pain in children", Can Fam Physician, 42, pp.1156~1164 (1996)
- Selbst SM, "Consultation with the specialist. Chest pain in children", Pediatr Rev, 18, pp.169~173 (1997)
- Evangelista JA, "Chest pain in children: diagnosis through history and physical examination", J Pediatr Health Care, 14, pp.3~8 (2000)
- Selbst SM, "Pediatric chest pain: a prospective study", Pediatrics, 82, pp.319~323 (1988)
- Rowe BH, "Characteristics of children presenting with chest pain to a pediatric emergency department", CMAJ, 143, pp.388~394 (1990)
- Kocis KC, "Chest pain in pediatrics", Pediatr Clin North Am, 46, pp.189~203 (1999)
- Woolf PK, "Noncardiac chest pain in adolescents and children with mitral valve prolapse", J Adolesc Health, 12, pp.247~250 (1991)
- Berezin S, "Esophageal chest pain in children with asthma", J Pediatr Gastroenterol Nutr, 12, pp.52~55 (1991)
- Hsia PC, "Utility of upper endoscopy in the evaluation of noncardiac chest pain", Gastrointest Endosc, 37, pp.22~26 (1991)
- Berezin S, "Chest pain of gastrointestinal origin", Arch Dis Child, 63, pp.1457~1460 (1988)
- Katz PO, "Approach to the patient with unexplained chest pain", Semin Gastrointest Dis, 12, pp.38~45 (2001)
- Lipsitz JD, "Noncardiac chest pain and psychopathology in children and adolescents", J Psychosom Res, 59, pp.185~188 (2005)
- 신수아, "흉부 통증을 호소한 소아에서의 임상적 고찰 및 검사", Korean Journal of Pediatrics, 46(12), pp.1248~1252 (2003), 대한소아과학회
- Cheung TK, "Noncardiac chest pain--an Asia-Pacific survey on the views of primary care physicians", Dig Dis Sci, 52, pp.3043~3048 (2007)
