Endoscopic Examinations in Children with Recurrent Abdominal Pain

Much difficulties are often encountered in finding the underlying cause of recurrent abdominal pain. Clinical features may vary from one patient to the other and occasionally from one episode to the next even in the same child. The recent development of fibre optic endoscopy may well prove to have a useful diagnostic technique, particularly in those children in whom other investigations are inconclusive. The result of endoscopic examinations in children with recurrent abdominal pain comprising of 62 children aged between 3-13 years were as follows: erosion in 7 children, oesophagi tis in 4 children, duodenitis in 3 children, spasm of the pylorus in 2 children, and normal findings were found in 30 children. Of the 30 patients with "normal" endoscopic findings, 7 had psychosomatic problems, 4 had allergy, 4 had urinary tract infection, 2 showed giardiasis, one had epilepsy, 1 was treated as pulmonary tuberculosis, where as in 11 patients organic as well as nonorganic abnormalities could not be found. There seem to be of no significant correlation between the endocopic and upper gastrointestinal series findings. Endoscopy seem to be of a safe and reliable tool in the diagnosis of a number of organic intestinal lesions otherwise not detected by ordinary investigations.

Rhinofibroscopic and Rhinomanometric Evaluation of Patients with Maxillary Contraction Treated with Rapid Maxillary Expansion. A Prospective Pilot Study

Objective: The aim of this study was to evaluate through nasal fiber optic endoscopy and rhinomanometry the patency of upper nasal airways in patients treated with rapid palatal expansion Study design: 30 patients (12 males and 18 females) aged 7–11 years with transverse maxillary constriction underwent rhinomanometric and fiberoptic examination before (T0) and after rapid palatal expansion (T1).The amount of nasopharynx obstruction was quantified with reference to the full choanal surface. Nasal resistance was recorded separately for right and left sides, and combined for both sides. The differences in nasopharynx obstruction and in nasal resistance between T0 and T1 were statistically evaluated. Results: The amount of nasopharynx obstruction significantly decreased after palatal expansion (p<0.001). Total nasal inspiration and expiration resistance significantly decreased at T1 (p<0.001). The reduction ranged between 0. 23 and 0. 66 Pa/cm3/s for inspiration and between 0. 20 and 0,.58 Pa/cm3/s for expiration. A statistically significant positive correlation existed between the T1-T0 differences in the amount of nasopharynx obstruction and the T1-T0 differences in expiration nasal airway resistance (Spearman's correlation coefficient rho = 0.38; p = 0.03). Conclusions: Rapid maxillary expansion has an influence on nasal resistance and improves the patency of upper airways in patients with minor or moderate breathing problems.