volume 12, issue 3, december 2011 - evaluation and management of the pediatric patients...

Volume 12, Number 3, December 2011 171

REVIEW ARTICLE

Evaluation and Management of the Pediatric Patients

Badriul Hegar*, Yvan Vandenplas**

*Department of Child Health, Faculty of Medicine, University of IndonesiaDr. Cipto Mangunkusumo General National Hospital, Jakarta, Indonesia

** UZ Brussel Kinderen, Vrije Universiteit Brussel, Belgia

ABSTRACT

Keywords

ABSTRAK

Kata kunci

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy172

Badriul Hegar, Yvan Vandenplas

1

2

children2

Gastrointestinal obstruction Pyloric stenosisMalrotation with intermittent volvulusIntestinal duplicationHirschsprung diseaseAntral/duodenal webForeign bodyIncarcerated hernia

Other gastrointestinal disorders

AchalasiaGastroparesisGastroenteritisPeptic ulcerEosinophilic esophagitis/gastroenteritisFood allergy

PancreatitisAppendicitis

Neurologic HydrocephalusSubdural hematomaIntracranial hemorrhageIntracranial massInfant migraineChiari malformation

Infectious SepsisMeningitisUrinary tract infectionPneumoniaOtitis mediaHepatitis

Metabolic/endocrine GalactosemiaHereditary fructose intoleranceUrea cycle defectsAmino and organic acidemiasCongenital adrenal hyperplasia

Renal Obstructive uropathy

Toxic LeadIronVitamin A and DMedications–ipecac, digoxin, theophylline, etc

Cardiac Congestive heart failureVascular ring

Others(Munchausen syndrome by proxy)Child neglect or abuseSelf induced vomitingCyclic vomiting syndromeAutonomic dysfunction


Evaluation and Management of the Pediatric Patients with Suspected Gastroesophageal Reflux Diseases

5

6

Table 2. History of children with suspected gastroesophageal 2

Feeding and dietary history

Amount/frequency (overfeeding)Preparation of formulaRecent changes in feeding type or techniquePosition during feedingBurpingBehavior during feeding: choking, gagging, cough, arching, discomfort, refusal

Pattern of vomiting

Frequency/amountPainForcefulBlood or bileAssociated fever, lethargy, diarrhea

Past medical history

PrematurityGrowth and development Past surgery, hospitalizationsNewborn screen resultsRecurrent illnesses, especially croup, pneumonia, asthmaSymptoms of hoarseness, fussiness, hiccups, apneaPrevious weight and height gainOther chronic conditions

Medications Current, recent, prescription, non-prescription

Family psycho-social history

Sources of stressMaternal or paternal drug usePost partum depression

Family medical history Family history of gastrointestinal disorders

Family history of atopy

Growth chart including height, weight and head circumference

Warning signals (see Table 3)

Table 3. Warning signals requiring investigation in infants with regurgitation or vomiting2 Bilious vomiting LethargyGastrointestinal bleeding: hematemesis, hematochezia

Hepatosplenomegaly

Consistently forceful vomiting Bulging fontanelleOnset of vomiting after 6 months of life Macro/microcephalyFailure to thrive SeizuresAbdominal tenderness or distension DiarrheaConstipation FeverDocumented or suspected genetic/metabolic syndrome

POOR WEIGHT GAIN



8

8

Not all

11

1



12

12

12



16

18

21

22



25

26

REFERENCES

Volume 12, Number 3, December 2011 179The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy178 The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy178


volume 12, issue 3, december 2011 - evaluation and management of the pediatric patients...

Documents