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Brunner's glands consist of submucosal mucinsecreting glands, which are located in the duodenum (1). Brunner's gland hyperplasia (BGH) is usually asymptomatic. A few cases causing obstruction, hemorrhage or intussusceptions in adults have been reported in the literature (2). We report a case of a 12-year-old boy with BGH presented with duodenal obstruction.A 12-year-old boy was admitted to our emergency department with significant vomiting and weight loss over the course of one week. On the present admission, physical examination revealed extensive abdominal tenderness, especially in the epigastric region. An upper endoscopy showed mild esophagitis, completely open pylorus and considerably widened bulb. The mucosa seen in the intersection between the first and second part of the duodenum was edematous and hyperemic, and the instrument did not pass through at that level because of severe narrowing (Figure 1). Barium examination of the upper gastrointestinal tract revealed that the stomach and the first part of the duodenum were distended, passage through the second part of the duodenum was delayed, and retrograde filling of the stomach was observed. Histological examination revealed BGH. Lobules of Brunner's glands were extended into the lamina propria and were separated by delicate fibrous septa ( Figure 2). The cells constituting the glands were cytologically bland and showed no mitotic activity. An antral biopsy specimen was negative for Helicobacter pylori, and serum gastrin level was within normal limits. An abdominal computed tomography was performed, which showed an enlarged stomach and bulb, but no masses were detected. According to the subsequent assessment made together with pediatric surgery and radiology, the patient un-

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Ç Ço oc cu uk kl lu uk k ç ça a¤ ¤› › p pa an nk kr re ea at ti it tl le er ri i: : 2 20 0 v va ak ka an n› ›n n k kl li in ni ik k a an na al li iz zi i P Pa an nc cr re ea at ti it ti is s i in n c ch hi il ld dh ho oo od d: : C Cl li in ni ic ca al l a an na al ly ys si is s o of f 2 20 0 c ca as se es s G Gö ön nü ül l D Di in nl le er r Ç Ça al lt te ep pe e, , Ö Öz zl le em m K K› ›r rm me em mi ifl fl, , A Ay yh ha an n G Ga az zi i K Ka al la ay yc c› › Ö Öz zg gü ün n A Ar ra afl flt t› ›r rm ma a O Or ri ig gi in na al l A Ar rt ti ic cl le e Ö Öz ze et t Amaç: Çocukluk yafl grubunda pankreatitler çok s›k görülmemekte ve altta yatan risk etkenleri aç›s›ndan da eriflkinlerden farkl›l›k göstermektedir. Bu çal›flmada amac›m›z, pankreatit tan›s› ile izlenen hastalar›m›z›n belirgin özelliklerini ortaya koymakt›r.Gereç ve Yöntem: Son befl y›ll›k dönemde, klini¤imizde pankreatit tan›s› alan 20 hastan›n (19 akut, bir kronik pankreatit) hastalar›n klinik ve laboratuvar bulgular›, altta yatan risk etkenleri ve hastal›¤›n seyri geriye dönük olarak araflt›r›lm›flt›r. ‹statistik verileri, ortalama ±SD ve % ile ifade edilmifltir. Bulgular: Hastalar›n 14'ü k›z, 6's› erkekti. Yafl ortalamalar› 11,4±3,62 (2-18) y›ld›. Saptanabilen risk etmenlerinin bafll›calar›, sistemik hastal›klar (%15), ilaçlar (%15), biliyer hastal›klar (%15) ve travma (%10) fleklindeydi. Yinelemelerle seyreden bir kronik pankreatit olgusu kistik fibroz tan›s› alm›flt›. ‹ki hastada yineleyen ataklar izlendi (birinde kabakulak serolojik bulgusu saptand›, di¤erinde herhangi bir risk etkeni saptanamad›). Ondokuz akut pankreatitli hastaya ait 22 akut atak de¤erlendirildi. Serum amilaz ve lipaz düzeyleri s›ras›yla hastalar›n %81,8 ve %90,9'unda yüksekti. Psödokist (%10), venöz tromboz (%10) ve nekrotizan pankreatit (%5) en s›k görülen komplikasyonlard›. Akut atak s›ras›nda ve izlemde kaybedilen hasta olmad›. Ç›kar›mlar: Sistemik hastal›klar, ilaçlar, biliyer hastal›klar ve travma çocukluk ça¤› pankreatitlerinin en önemli risk etkenlerini oluflturmaktad›r. Çocuklarda ölüm düflük olmakla beraber, özellikle fliddetli olgular, psödokist ve venöz tromboz gibi geliflebilecek komplikasyonlar aç›s›ndan yak›n izlenmelidir. (Türk Ped Arfl 2011; 46: 49-54)Anahtar sözcükler: Çocukluk ça¤›, L-asparajinaz, nekrotizan pankreatit, pankreatit, psödokist, valproik asit, venöz tromboz S Su um mm ma ar ry y Aim: Pancreatitis rarely occurs in childhood and the underlying causes differ from adults. The aim of this study is to evaluate the documentation of characteristics of our cases diagnosed as pancreatitis. Material and Method:Of the 20 patients (19 acute, one chronic) who diagnosed as pancreatitis in our clinic during a five year period were analyzed retrospectively, considering clinical and laboratory findings, underlying risk factors and outcome of the illness. Data were analysed with SPSS 16.0 computer package programme. Results:Of the 20 patients 14 were female and 6 were male. The mean age was 11.4±3.62 (2-18) years. The most common risk factors were systemic disease...

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