The relationship between Helicobacter pylori infection and acid-hematuria syndrome in pediatric patients with gastric augmentation-II.
OBJECTIVE
The acid-hematuria syndrome, which presents with dysuria, hematuria, and perineal pain still remains a problem in those patients who have undergone bladder augmentation using the gastrocystoplasty technique. Additionally, there is still a question regarding the explanation for postoperative metabolic problems such as metabolic alkalosis, hypocholoremia, hypergastrinemia, and various complications related to gastritis and peptic ulcer disease. The aim of this study was to investigate the relation of Helicobacter pylori (HP) infection in this patient group and the relationship between HP infection and the above-mentioned clinical problems and complications.


METHODS
In this study, 10 children with a history of previous gastrocystoplasty (five girls, five boys; mean age, 6.75+/-2.53 years; range, 2.5 to 12 years) were evaluated. Blood samples for HP detection were analyzed by serological testing (ELISA technique). Histopathologic studies were performed for gastric tissue specimens, obtained by endoscopic procedures from the stomach and augmented bladder. Urine pH and serum gastrin levels were measured in all patients.


RESULTS
Regarding the serological studies, four of ten patients had a positive ELISA test result (40%). The four patients with HP-positive serological test results, were the patients who had acid-hematuria syndrome. These patients also had low urine pH levels (mean, 4.5) when compared with those of HP-negative patients. HP-positive patients also had high serum gastrin levels in comparison with those of HP-negative patients.


CONCLUSIONS
The relation between HP infection and problems such as hypergastrinemia, acid output, and ulcer disease is well known. Our study demonstrates a correlation between the HP-positive gastrocystoplasty patients and the above-mentioned symptoms and complications. Because of the potential risk of HP infection, we suggest that HP infection be investigated in patients with gastrocystoplasty or in candidates for a gastrocystoplasty operation. HP-positive patients should be treated, to reduce the risks of postoperative complications.
Celayir
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Department of Pediatric Surgery, Cerrahpaşa Medical Faculty, University of Istanbul, Turkey.
Göksel
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Büyükünal
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D001746:Bladder Exstrophy / Q000601:surgery*; D002648:Child; D005260:Female; D005744:Gastric Acid; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D016480:Helicobacter pylori; D006417:Hematuria / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology*; D013270:Stomach / Q000382:microbiology / Q000601:surgery*; D019738:Surgically-Created Structures / Q000382:microbiology; D013577:Syndrome; D013520:Urologic Surgical Procedures