ObjectivesThe aim of this study was to determine the effect of cystic fibrosis (CF) on pancreas and liver elasticity in young children using point shear wave elastography and to determine the relationship with clinical findings.MethodsTwenty‐two patients with genetically proven CF, who were admitted to our pediatric gastroenterology clinic, and 22 healthy control participants were enrolled in the study. The shear wave velocity (SWV) of the liver and pancreas were measured with point shear wave elastography.ResultsThe 22 patients with CF included 45.5% girls with a mean age ± SD of 35 ± 35.8 months (range, 5–123 months). The 22 healthy control participants included 41.2% girls with a mean age of 58.9 ± 44.4 months (range, 2–159 months). The mean SWV of the pancreas in the patients with CF (1.06 ± 0.26 m/s) was significantly higher than that of the healthy control participants (0.85 ± 0.23 m/s; P = .01). The mean SWV of the liver in the patients with CF (1.46 ± 0.24 m/s) was significantly higher than that of the healthy control participants (1.12 ± 0.21 m/s; P = .001). The SWV of the pancreas and liver did not show any significant differences depending on ursodeoxycholic acid use, malnutrition status, and the presence of the F508 deletion mutation.ConclusionsThis study showed an increased SWV of the pancreas in children with CF, contrary to the literature. We also found an increased liver SWV even in the absence of CF‐related liver disease. Ultrasound elastography may be a useful method of evaluating early changes in the pancreas and liver before the obvious clinical, laboratory, and B‐mode ultrasound signs of CF‐related involvement.

Objective: Unlike adults, gallbladder polyps (GPs) are rare in childhood. The aim of this study was to evaluate patients with a GP diagnosis. Methods: Patients who were diagnosed with GP via ultrasonography from October 2012 to October 2017 were retrospectively evaluated in terms of sociodemographic characteristics and laboratory findings. Results: The study included 19 patients diagnosed with GP and followed up in our department. The patients comprised 14 (73.6%) girls with a mean age of 13.9 ± 4.1 years and a mean follow-up period of 10.2 ± 5.4 months (range, 3–26 months). The most common presenting symptom of the patients (n = 15, 78.9%) for ultrasonography was abdominal pain without biliary symptoms. Location of the polyps was in the corpus in 55% of patients, and either in the fundus (20%) or the neck of the gallbladder (25%). The average diameter of the polyps was 4.5 ± 1.6 mm (range, 2–9 mm). Multiple polyps were observed in 3 patients. No significant change in the number or size of polyps was noted at the end of the follow-up periods. Cholecystectomy was applied to 1 patient who had >5 polyps with a rapid increase in size, and the pathology report was hamartomatous polyp. There was no remarkable change in the clinical or laboratory findings of other patients during the follow-up period. Conclusion: In this study, GPs could be seen in young children as young as 16 months of age and ultrasonography is sufficient for follow-up in stable and asymptomatic patients.

Children with classical AATD commonly have chronic liver disease. In heterozygous (PiMZ) children with AATD, enzyme levels can normalize with occasional fluctuations, sometimes causing delayed diagnosis.

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BACKGROUND: Gastritis consists of inflammation of the gastric mucosa and is one of the main causes of dyspeptic symptoms in children. OBJECTIVE: To investigate the presence of inflammation by evaluating fecal calprotectin (FC) in children diagnosed with chronic gastritis.

Background Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent episodes of fever and serosal inflammation. The aim of this study was to evaluate fecal calprotectin (FC) in children with FMF during the non‐attack period. Methods A retrospective evaluation was made of the data of a total 66 patients diagnosed with FMF in an attack‐free period and without amyloidosis or inflammatory bowel disease (IBD). FC level in the FMF patients was compared with that in the patients with IBD and healthy control subjects. Results The FMF patients consisted of 37 boys (56.1%) with a mean age of 10.1 ± 3.9 years. Mean FC was 192.5 μg/g (range, 19.5–800 μg/g) in the FMF group, 597.9 μg/g (range, 180–800 μg/g) in the IBD group, and 43.8 μg/g (range, 19.5–144 μg/g) in the control group. The FC level in the children with FMF was higher than in the control group (P < 0.001), and the FC level of the IBD patients was higher than both the FMF and the control groups (P = 0.020, P < 0.001, respectively). Conclusions FC was higher in FMF patients compared with healthy children even in the absence of IBD/amyloidosis. Even though colonoscopy is the gold standard in identifying intestinal inflammation in FMF patients, FC, a non‐invasive and inexpensive method, can be used for screening. The presence of subclinical intestinal inflammation was also quantitatively identified in children with FMF.

Data regarding the role of endoscopic ultrasonography (EUS) in pediatric chronic/ recurrent pancreatitis (CP/RP) is limited. The aim of this study is to evaluate the role of EUS in the diagnosis and clinical observation of RP in childhood. Between September 2016 and September 2017 EUS findings of 17 patients with RP and 20 patients in a control group were evaluated retrospectively, and the findings were compared. The control group consisted of patients who underwent EUS for cholecystolithiasis but had no pancreatitis. The most common EUS finding was ≥3 mm hyperechoic strands in 15 (88.2%) of the patients. According to the Conventional criteria, 11 patients (64.7%) had pathological findings ≥3. No patient in this study fulfilled the Rosemont criteria for the definitive diagnosis of CP. In the comparison of the EUS findings of the pancreatitis cases to the control group, hyperechoic strands ≥3mm in the pancreatic parenchyma (p&lt;0.001), lobularity (p=0.004), duct dilatation (p= 0.009) and hyperechoic duct margin (p&lt;0.001) were determined to have statistically significant differences. In this study, hyperechoic line is the most common EUS finding of pancreatitis in childhood. The threshold number of EUS criteria for the diagnosis of CP in pediatric patients is unclear. However, in our opinion, the Conventional criteria are more suitable than the Rosemont criteria for the diagnosis of CP in childhood. Further studies are needed in this field.