title: Prevalence and Clinical, Endoscopic, and Pathological Features of Duodenitis in Children.
abstract: OBJECTIVE
  Although gastritis and esophagitis are well studied in children, there is very limited literature on duodenitis in children. We aimed to assess the prevalence, etiology, clinical, endoscopic, and pathological features in a large cohort of unselected children with duodenitis.
  
  
  METHODS
  We reviewed the pathology reports of all the upper endoscopies performed at our institution during 5 years to identify children with duodenitis. Biopsy sections were reviewed to confirm the diagnosis of duodenitis. Demographic, clinical, endoscopic data, and the presence of associated gastritis and esophagitis were noted in all of the children with duodenitis. The etiology of duodenitis was correlated with the patients' clinical diagnosis.
  
  
  RESULTS
  Out of 2772 children who had endoscopy, 352 had duodenitis with the prevalence rate of 12.7%. Gastritis was seen in 64% of children with duodenitis compared with 46% of children without duodenitis (P < 0.001). Common indications for endoscopy in children with duodenitis were abdominal pain, positive celiac serology, and diarrhea. The most common etiology was celiac disease (32%), followed by Crohn disease (13%), ulcerative colitis (3%), and Helicobacter pylori infection (6%). In 63% of cases, the endoscopic appearance of duodenum was normal. Cryptitis, villous changes, and cellular infiltration were noted on histology.
  
  
  CONCLUSIONS
  Prevalence of duodenitis is 12.7% in children undergoing endoscopy. Celiac disease and inflammatory bowel disease are common causes of duodenitis. Associated gastritis is common in children with duodenitis, and the correlation of endoscopic appearance with histology is poor.
authors.affiliation: *Department of Pediatrics, Division of Pediatric Gastroenterology †Department of Pathology, Yale University School of Medicine, New Haven, CT.
authors.forename: Arik
authors.initials: A
authors.lastname: Alper
authors.forename: Steven
authors.initials: S
authors.lastname: Hardee
authors.forename: Danilo
authors.initials: D
authors.lastname: Rojas-Velasquez
authors.forename: Sandra
authors.initials: S
authors.lastname: Escalera
authors.forename: Raffaella A
authors.initials: RA
authors.lastname: Morotti
authors.forename: Dinesh S
authors.initials: DS
authors.lastname: Pashankar
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000293:Adolescent; D002446:Celiac Disease / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000150:complications; D003424:Crohn Disease / Q000150:complications; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology; D004382:Duodenitis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D004386:Duodenum / Q000473:pathology*; D004724:Endoscopy; D005260:Female; D005756:Gastritis / Q000453:epidemiology / Q000209:etiology; D016481:Helicobacter Infections / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence