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Heterotopic gastric mucosa (HGM) can be found anywhere from the mouth to the rectum. Moreover, anecdotal presence at airways, umbilicus, gallbladder, biliary tree, urinary bladder, and scrotum was reported (1-3). Here we present a 15-year-old girl referred to our clinic with recurrent hematemesis, because of duodenojejunal HGM. Her physical examination was normal except pallor (serum hemoglobin level: 7.2 g/dL). Gastroduodenoscopy revealed a huge, snake-like polypoid lesion obliterating the lumen of the distal duodenum and extending farther (Fig. 1A). Oxyntic mucosa was detected on biopsy specimens by hematoxylin-eosin staining (Fig. 1B). Computed tomography showed a 12 Â 5 cm mobile mass in the lumen of the fourth part of the duodenum. At laparotomy, a mass was found starting approximately from 4 cm proximal to the ligament of Treitz and continued to 8 cm distal of Treitz, and was resected (Fig. 2).HGM is a rare hereditary or acquired condition, usually seen in adults. Children would present with recurrent hematemesis or melena (4). Residual acid and gastrin-secreting tissues are commonly located on the duodenum; however, presence on jejunum, colon, and esophagus has all been described previously (5). Pediatric gastroenterologists should be aware of HGM in patients with upper gastrointestinal (GI) bleeding.

Introduction Bronchiolitis obliterans (BO) is mainly caused by infections and hematopoietic stem cell transplantation (HSCT). This study aimed to investigate the health‐related quality of life (HRQOL) of children with BO compared to the healthy children and also to assess the HRQOL according to the etiology. Methods Postinfectious (group 1) and post‐HSCT BO (group 2) patients and healthy children were included in the study. HRQOL was assessed by the Short Form‐36 (SF‐36) and St George's Respiratory Questionnaire (SGRQ). Correlations between demographic and clinical characteristics, pulmonary function tests, high‐resolution chest tomography scores, and HRQOL were assessed. Results Thirty‐seven postinfectious and post‐HSCT BO patients and 34 healthy children were included in the study. Mean age was 13.8 ± 0.7 years. Mean forced vital capacity and forced expiratory volume1 were 60.7 ± 2.7% predicted, and 49.8 ± 3.1% predicted, respectively. The SF‐36 scores were lower in BO patients compared to healthy children (P < .01). Patients with better lung functions had higher SF‐36 scores, but lower SGRQ. The number of inhaled therapies, acute exacerbations, hospitalizations were inversely correlated with SF‐36. A positive correlation was found between these parameters and total SGRQ scores (r = .507, P = .02; r = .409, P = .12; r = .326, P = .049, respectively). SF‐36 scores were better in group 1 for subscales of physical role functioning and social role functioning compared to group 2. (P = .01, P = .01, respectively). Conclusion The HRQOL of patients with BO measured by SF‐36 was low compared to healthy children. SF‐36 scores were more affected in post‐HSCT BO patients. HRQOL of children with chronic lung disease should be taken into consideration in the management of these patients.

Background Diabetes and hepatosteatosis are dramatically increasing in childhood. Non-alcoholic fatty liver disease (NAFLD) is defined as a common disorder in adulthood, especially with type-2 diabetes and metabolic syndrome, while very few studies are available on liver health in children with type-1 diabetes. Patients and methods One hundred and ten (52 males and 58 females) patients with type-1 diabetes aged between 8 and 18 years were examined. The lipid profile, liver enzymes and hepatobiliary ultrasound findings of patients were investigated in terms of hepatopathies. Patients diagnosed with fatty liver were evaluated by pediatric gastroenterology specialists for the differential diagnosis and exclusion of other etiologies. The relationships between hepatopathy and age, pubertal status, the duration of diabetes and glycemic control were evaluated. Results Hepatopathy was found in 17 (15.5%) patients. The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were normal and did not correlate with the ultrasonography (USG) findings. Hyperechogenicity detected by USG, whether it is true fat or glycogen hepatopathy, was found to be associated with “poor glycemic control” independently of age, puberty status and the duration of diabetes. Conclusions This study contributes to the literature in terms of the relationship between liver health and glycemic control in pediatric type-1 diabetes. Hepatopathies were releated with poor glycemic control independently of the duration of diabetes. This suggested that liver disorders should be considered as one of the subacute complications of diabetes. It was concluded that routine screening for comorbidities and complications in type-1 diabetes should also include hepatobiliary USG, as liver enzymes alone are inadequate for detecting hepatopathies.

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Determination of the serum activity of pancreatic isoamylase was performed in 30–6 5-year-old men seeking primary health care centers for dyspepsia. Of 36 consecutive patients 7 had abnormal pancreatic isoamylase activity in serum. This figure indicates dyspepsia to be commonly associated with pancreatic disease such as chronic pancreatitis.

Objectives: In this study, we present our clinical severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) experience in patients with childhood rheumatic disease during novel coronavirus-2019 (COVID-19) pandemic. Patients and methods: A total of 87 patients (50 males, 37 females; median age: 12 years; range, 6.6 to 16 years) suspected of having COVID-19 at our pediatric rheumatology clinic between March 11 th and October 15 th 2020 were retrospectively analyzed. Demographic and clinical features, treatments, laboratory results, imaging findings, and clinical outcomes of the patients diagnosed with COVID-19 and/or multisystem inflammatory syndrome in children (MIS-C) were retrieved from the medical records. The diagnosis of SARS-CoV-2 infection was made based on the reverse transcriptase-polymerase chain reaction test. Results: The most common rheumatic diseases were juvenile idiopathic arthritis and familial Mediterranean fever (35.6% and 34.5%, respectively). Twenty-six of these patients were treated with biological disease-modifying anti-rheumatic drugs. SARS-CoV-2 infection was tested as positive in 84 (96.5%) patients. Also, 51 (58.6%) patients had an epidemiological contact to a person with COVID-19. Eighteen patients met the clinical criteria and diagnosed with MIS-C. The COVID-19 outbreak also caused exacerbation of systemic disease in 56 children due to medication cessation, postponed drug switch, or recurrent viral infection. Conclusion:Children with rheumatic disease do not appear to present a higher risk of severe COVID-19. The immunosuppressive treatments can be adjusted in case of infection; otherwise, it is not recommended to interrupt the treatments. Physicians should be cautious about the hyperinflammatory syndrome associated with COVID-19 in rheumatic children, which may be severe in this group of patients and may be confused with primary diseases.