[Pediatric proctology].

The approach to proctologic disorders has been little studied in the child. The region is, however, easily accessible for direct examination, and the predominant abnormalities are the rectal consequences of passing hard and/or voluminous stools that are often responsible for pain and bleeding. Other lesions are also observed (pseudo-haemorrhoidal vascular swelling, abscess, dermal scar proliferation, prolapsus) but are generally easily diagnosed and treated, although in a paediatric context.

Sucrase-isomaltase deficiency: changing pattern over two decades.

Twenty-two cases of sucrase-isomaltase deficiency (SID) were observed over a period of 20 years. Since 1977 delay of introduction of sucrose and its decrease in infants' diets have modified the symptomatology. In general, onset of diarrhea has not taken place immediately but 15 days to 2 months after introduction of sucrose.

[Sarcoidosis in children with digestive manifestations].

Background: Gastric involvement is the least rare among digestive localizations of sarcoidosis, as well in adults as in children. When it is to be seen at the beginning of the disease, it may cause difficulties in the diagnostic, especially with Crohn's disease.

Case Report: Gastric ulcers were detected in a 12 year-old girl, of African origin, who complained about epigastric pain.

[Therapeutic evaluation of Mormoiron attapulgite in acute diarrheas of infants and children. A multicenter study in controlled liberal practice versus placebo in 113 patients].

A placebo-controlled multicenter study was carried out to evaluate the effectiveness and safety of Actapulgite in infants and children with acute diarrhea. One hundred and thirteen patients, with a mean age of 28 months, were enrolled by pediatricians in the office. As recommended during acute diarrhea, the dosage of Actapulgite was doubled during the first three treatment days (2 to 4 packets a day according to the patient's weight), and reduced by half thereafter.

[Value of esogastroduodenal endoscopy with staged biopsies in children with Crohn's disease].

An upper gastrointestinal endoscopy with multiple biopsies was performed in 19 children suspected of Crohn disease (CD) who had also undergone X-ray investigations and colonoscopy with multiple biopsies. Biopsies were performed in pathological and/or normal mucous areas. Upper gastrointestinal endoscopy showed macroscopic changes in 7 children (37%).

Prolonged constant rate elemental enteral nutrition in Crohn's disease.

Constant rate enteral nutrition (CREN) has been used in 17 pediatric patients with Crohn's disease. Exclusive CREN was maintained from 2 to 7 months and progressively reduced to assure fractioned oral intakes from 12 to 22 months. From this preliminary study, CREN appeared to be as effective as steroid therapy in initiating remission of active Crohn's disease and was able to suppress steroid dependence.

[A study of immunoglobulin-producing cells in the colonic mucosa of children with Crohn's disease (author's transl)].

The immunoglobulin-producing cells of the rectal and colonic mucosae were studied on 12 biopsies obtained from 6 children, aged from 13 to 18 years, suffering from Crohn's disease involving the ileum and colon or the colon only. After incubation with immune sera specifically directed against alpha, gamma and mu chains, the fluorescent plasmocytes present in a predetermined surface area of the chorion were counted in the patients and in a control group of 5 children. Compared with controls, children with Crohn's disease had less IgA-producing plasmocytes per surface area (mean: 32.

[Constant rate enteral feeding in the patient's home. Clinical experience in paediatrics (111 children) (author's transl)].

Constant rate enteral feeding in the patient's home considerably shortens the stay of children in a specialized pediatric unit. A study of 111 children treated by this method for the past 5 years shows that, provided close co-operation with the family is obtained, obvious psychological benefits can be expected with little risk of technical complications. From an economic point of view, the method provides an effective means of reducing costs.