Clinical Outcomes of Pediatric Chronic Intestinal Pseudo-Obstruction

Ko, Dayoung; Yang, Hee-Beom; Youn, Joong Kee; Kim, Ho

doi:10.3390/jcm10112376

Cited by 11 publications

(14 citation statements)

References 24 publications

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“…Amplitude: Since a higher amplitude of contractile activity could be detected in patients with intestinal neuropathy, 21,36,37 and the maximum amplitude of phase III contraction reported in children was approximately 50 mmHg, 20 the amplitude of >50 mmHg was scored "1". Based on previous studies, [37][38][39] myopathy is related to poor outcome (either death or parenteral nutrition dependence).…”

Section: A Ppen D I X I Nter D I G E S Ti V E S Tate Phase Iii Of Mmcmentioning

confidence: 99%

Enhancing the utility of antroduodenal manometry in pediatric intestinal pseudo‐obstruction

Chanpong

Cronin

Rampling

et al. 2021

Neurogastroenterology Motil

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Background Antroduodenal manometry (ADM) and histopathology are currently employed to aid the diagnosis of pediatric intestinal pseudo‐obstruction (PIPO). Limited data are available on the reliability of ADM analysis and its correlation with histopathology. We aimed to develop a protocol for enhanced analysis of ADM contractile patterns, including a scoring system, and explore whether this provided better correlation with histopathology. Methods Children referred with suspected PIPO between April 2012‐December 2019 who underwent both ADM and full‐thickness biopsies were included. ADM tracings were analyzed using both standard (conventional ADM) and novel (enhanced ADM) motility parameters. A novel ADM score (GLASS score) was generated based on the enhanced ADM analysis. Conventional and enhanced ADM analyses were then correlated with histopathology. Results Forty patients were included. Using conventional clinical criteria, 29 of these were diagnosed with PIPO and the other 11 with non‐PIPO diagnoses. Twenty‐three of the PIPO patients had abnormal histopathology: 6 myopathy, 4 neuropathy, 3 neuro‐myopathy, and 10 non‐specific changes. No agreement in diagnosis was found between conventional ADM analysis and histopathology (ϰ = 0.068; p = 0.197), whereas the latter significantly correlated with enhanced ADM analysis (ϰ = 0.191; p = 0.003). The enhanced ADM score was significantly higher in PIPO versus non‐PIPO (16.0 vs. 8.0; p < 0.001). Conclusions As opposed to conventional analysis protocols, the newly developed enhanced ADM analysis and associated score is not only able to discriminate between PIPO and non‐PIPO patients, but also between distinct histopathological pathologies. Further studies are required to assess the utility of enhanced ADM analysis in larger populations.

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Section: A Ppen D I X I Nter D I G E S Ti V E S Tate Phase Iii Of Mmcmentioning

confidence: 99%

Enhancing the utility of antroduodenal manometry in pediatric intestinal pseudo‐obstruction

Chanpong

Cronin

Rampling

et al. 2021

Neurogastroenterology Motil

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“…Patients with myopathic PIPOs are reported to have poor outcomes. 14 In this study, patients with myopathy had a significantly higher mortality rate (69.2%) than those without myopathy (26.2%). In addition, the EO-PIPO group had a higher rate of myopathy (36.4%) than the LO-PIPO group (4.8%).…”

Section: Discussionmentioning

confidence: 52%

“…Pathologic types of PIPO are known to be important prognostic factors. Patients with myopathic PIPOs are reported to have poor outcomes 14 . In this study, patients with myopathy had a significantly higher mortality rate (69.2%) than those without myopathy (26.2%).…”

Section: Discussionmentioning

confidence: 53%

Long‐term follow‐up for pediatric intestinal pseudo‐obstruction patients in China

Tang

Yan

et al. 2022

Nut in Clin Prac

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Background: Pediatric intestinal pseudo-obstruction (PIPO) is a heterogeneous and severe group of disorders with a high mortality rate. Patients with PIPO often develop malnutrition and need long-term nutrition support. This study aimed to determine the nutrition status, particularly micronutrients, during the long-term follow-up of patients with PIPO.Methods: Fifty-eight patients with PIPO were followed up for at least 6 months between January 2008 and December 2020 in our hospital. PIPO was diagnosed based on the European society for pediatric gastroenterology, hepatology, and nutrition consensus. Data on clinical characteristics, medical and surgical management, nutrition support, serum vitamins, and mineral concentrations were collected. The patients were divided into the early-onset PIPO (EO-PIPO; neonatal-onset) and late-onset PIPO (LO-PIPO; infant-or child-onset) groups. Results: The mean follow-up was 29.5 months (6-153 months). The overall survival rate was 63.8% (37 out of 58 participants) (EO-PIPO, 48.6% [17 out of 35 participants]; LO-PIPO, 87.0% [20 out of 23 participants]). Mortality in the EO-PIPO group was higher than in the LO-PIPO group (P = 0.002). Twentyone patients died, of which 18 (85.7%) patients had EO-PIPO and 14 (66.7%) patients died under 1 year of age. Infection was the major cause of death.Severe malnutrition was observed at baseline and during follow-up in 25 (43.1%) and 6 (16.2%) patients, respectively. At baseline and during follow-up, the zinc deficiency rates were 29.6% and 26.3%, and those of vitamin D were 26.9% and 52.6%, respectively. Conclusions: Zinc and vitamin D deficiencies are common in patients with PIPO during follow-up. Therefore, additional supplements should be recommended.

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“…Most, if not all, of children with PIPO receive multiple surgical interventions, unfortunately many of these prior to a definitive diagnosis [ 98 , 99 ]. To date, the detection of viral particles in GI specimens is rarely described in PIPO patients.…”

Section: Pathogens and Ens Development And Diseasementioning

confidence: 99%

The Potential Role of Microorganisms on Enteric Nervous System Development and Disease

2023

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The enteric nervous system (ENS), the inherent nervous system of the gastrointestinal (GI) tract is a vast nervous system that controls key GI functions, including motility. It functions at a critical interface between the gut luminal contents, including the diverse population of microorganisms deemed the microbiota, as well as the autonomic and central nervous systems. Critical development of this axis of interaction, a key determinant of human health and disease, appears to occur most significantly during early life and childhood, from the pre-natal through to the post-natal period. These factors that enable the ENS to function as a master regulator also make it vulnerable to damage and, in turn, a number of GI-motility disorders. Increasing attention is now being paid to the potential of disruption of the microbiota and pathogenic microorganisms in the potential aetiopathogeneis of GI-motility disorders in children. This article explores the evidence regarding the relationship between the development and integrity of the ENS and the potential for such factors, notably dysbiosis and pathogenic bacteria, viruses and parasites, to impact upon them in early life.

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Clinical Outcomes of Pediatric Chronic Intestinal Pseudo-Obstruction

Cited by 11 publications

References 24 publications

Enhancing the utility of antroduodenal manometry in pediatric intestinal pseudo‐obstruction

Enhancing the utility of antroduodenal manometry in pediatric intestinal pseudo‐obstruction

Long‐term follow‐up for pediatric intestinal pseudo‐obstruction patients in China

The Potential Role of Microorganisms on Enteric Nervous System Development and Disease

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