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Antecedentes: el pólipo gastrointestinal es un tumor o crecimiento localizado que protruye desde la pared hacia la luz intestinal. Su manifestación clínica más común es la rectorragia recurrente; también puede causar dolor abdominal, prolapso del pólipo por el recto, prurito, dolor después de la defecación, diarrea mucosa o constipación de vientre. La colonoscopia es el procedimiento de elección para diagnosticar y tratar los pólipos.Objetivo: describir las características clínicas, colonoscópicas e histológicas de los pacientes pediátricos con poliposis colónica, atendidos en el Servicio de Gastroenterología y Nutrición del Instituto Nacional de Pediatría, México.Materiales y métodos: estudio observacional, transversal, retrospectivo, descriptivo. Se revisaron todos los expedientes de los pacientes a quienes se realizó estudio endoscópico del 4 de junio del 2010 al 31 de diciembre del 2013.Resultados: se revisaron 56 expedientes; 49 cumplían los criterios de inclusión con predominio del sexo masculino (59.2%). El síntoma principal de estos pacientes fue el sangrado moderado del tubo digestivo bajo no anemizante en 41 casos (83.7%); la localización más frecuente fue rectal (51%).Conclusiones: en pacientes preescolares y escolares con hemorragia de tubo digestivo bajo “no anemizante”, la primera posibilidad diagnóstica es un pólipo que debe ser diagnosticado, tratado y, en su caso, seguido por el tiempo necesario.

Background Cow's milk protein allergy is the most common cause of food allergy. The challenge test, either open or doubled-blind with a placebo control, is regarded as the criterion standard. Endoscopy and histologic findings are considered a method that can aid in the diagnosis of this entity. Aims The aim of this study was to describe the histopathologic findings in children suspected of cow's milk protein allergy that were seen at our hospital. Material and methods A descriptive, observational study was conducted on 116 children clinically suspected of presenting with cow's milk protein allergy that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatria . Upper endoscopy and rectosigmoidoscopy with biopsies were performed and the findings were described. Results Of the 116 patients, 64 (55.17%) were girls and 52 (44.83%) were boys. The rectum was the site with the greatest presence of eosinophils per field in both groups, followed by the duodenum. In general, more than 15 eosinophils were found in 46% of the patients. Conclusions Between 40 and 45% of the cases had the histologic criterion of more than 15 to 20 eosinophils per field and the rectosigmoid colon was the most affected site. Therefore, panendoscopy and rectosigmoidoscopy with biopsy and eosinophil count are suggested.

ResumenAntecedentesLa alergia a las proteínas de la leche de vaca es la causa más común de alergia a alimentos. La prueba de reto ya sea abierta o doble ciego controlado con placebo, es considerada el estándar de oro. La endoscopia y los hallazgos histológicos son considerados métodos que pueden ayudar en el diagnóstico de esta entidad.ObjetivosEl objetivo del presente trabajo fue describir los hallazgos histopatológicos en niños con sospecha de alergia a las proteínas de la leche de vaca atendidos en nuestro hospital.Material y métodoEstudio observacional, descriptivo en 116 niños con sospecha clínica de alergia a las proteínas de la leche de vaca, atendidos en el Departamento de Gastroenterología y Nutrición del Instituto Nacional de Pediatría. Se efectúo endoscopia alta y rectosigmoidoscopia con toma de biopsias y se describieron los hallazgos.ResultadosSe incluyeron 116 pacientes, 64 (55.17%) del género femenino y 52 (44.83%) masculino. El sitio con mayor presencia de eosinófilos fue el recto en ambos grupos, seguido del duodeno; en general se encontró más de 15 eosinófilos por campo en el 46% de los pacientes.ConclusionesEntre el 40-45% de los casos tuvieron el criterio histológico de más de 15-20 eosinófilos por campo siendo el sitio más afectado el rectosigmoides. Por lo tanto, se sugiere realizar panendoscopia y rectosigmoidoscopia con toma de biopsias y recuento de eosinófilos.AbstractBackgroundCow's milk protein allergy is the most common cause of food allergy. The challenge test, either open or doubled-blind with a placebo control, is regarded as the criterion standard. Endoscopy and histologic findings are considered a method that can aid in the diagnosis of this entity.AimsThe aim of this study was to describe the histopathologic findings in children suspected of cow's milk protein allergy that were seen at our hospital.Material and methodsA descriptive, observational study was conducted on 116 children clinically suspected of presenting with cow's milk protein allergy that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría. Upper endoscopy and rectosigmoidoscopy with biopsies were performed and the findings were described.ResultsOf the 116 patients, 64 (55.17%) were girls and 52 (44.83%) were boys. The rectum was the site with the greatest presence of eosinophils per field in both groups, followed by the duodenum. In general, more than 15 eosinophils were found in 46% of the patients.ConclusionsBetween 40 and 45% of the cases had the histologic criterion of more than 15 to 20 eosinophils per field and the rectosigmoid colon was the most affected site. Therefore, panendoscopy and rectosigmoidoscopy with biopsy and eosinophil count are suggested.

El reflujo gastroesofágico es el paso retrógrado del contenido gástricohacia el esófago, la enfermedad se produce cuando hay signos y síntomas.El método diagnóstico de elección ha sido la monitorización delpH intraesofágico; sin embargo, se han desarrollado nuevas técnicaspara apoyar el diagnóstico. Una de ellas es la impedanciometría, quese basa en el registro de los cambios en la impedancia eléctrica en ellumen gastrointestinal provocada por el paso de un bolo (aire, alimento,saliva, contenido gastroduodenal). Con este estudio podemos valorar:el patrón del movimiento retrógrado y anterógrado, duración del boloal deglutir o refluir, dirección y velocidad del movimiento esofágicoy detectar cualquier episodio de reflujo, ya sea ácido o no ácido. Elobjetivo de esta revisión es evaluar el uso de este método en niños encuanto a la técnica, indicaciones y beneficios para la vigilancia delpH intraesofágico.

ResumenEl síndrome de nevos azules ahulados (SNAA) es un síndrome poco frecuente, que se caracteriza por la presencia de múltiples malformaciones vasculares en piel y tracto gastrointestinal. También pueden verse afectados otros órganos con diferentes manifestaciones clínicas tales como artralgias, epistaxis, hemoptisis, hematuria, hemotórax, trombocitopenia leve, coagulopatía por consumo y deformaciones óseas, entre otras. Se presenta el caso en un niño de nueve años de edad con SNAA, con manifestaciones clínicas características, tales como lesiones cutáneas puntiformes de color violáceo con tamaño variable y malformaciones vasculares gastrointestinales con sangrado de tubo digestivo.AbstractBlue Rubber Bleb Nevus Syndrome (BRBS) is a rare disease, characterized by multiple vascular malformations in the skin and gastrointestinal tract. Other organs can also be affected, presenting different clinical manifestations such as arthralgia, epistaxis, hemoptysis, hematuria, hemothorax, mild thrombocytopenia, consumptive coagulopathy, and bone deformities, among others. We present a case of BRBS in a nine-year-old boy with the characteristic clinical manifestations of punctated purplish-blue skin lesions that vary in size and gastrointestinal vascular malformations with upper digestive tract bleeding.

The prevalence of cow's milk protein allergy (CMPA) has increased in recent years, and is associated with antimicrobial use during the perinatal period, prematurity, the type of childbirth, and the decrease in breastfeeding. The aim of this study was to analyze whether there is any association between these factors and the development of CMPA.A retrospective, comparative, cross-sectional, observational study was conducted by reviewing the case records of 101 children diagnosed with CMPA and seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría within the time frame of January 2012 and August 2013. The following variables were included: age, sex, weeks of gestation, history of maternal infection and antimicrobial use during the pregnancy, type of delivery, and feeding with human milk, and its duration. Likewise, the case records of 90 children were reviewed as a control group on not having CMPA or any other allergy. The chi-square test was used for proportions, and the Mann-Whitney U test was used for comparing means in the statistical analysis.The factors associated with CMPA were the use of antimicrobials during gestation and breastfeeding duration in months. Both factors were statistically significant (P.001). No association was found between CMPA and gestational age or type of delivery.The statistically significant associated factors were breastfeeding duration and the use of antimicrobials during the gestational stage. These results underline the necessity for prospective studies.

Cow's milk protein allergy is the most common cause of food allergy. The challenge test, either open or doubled-blind with a placebo control, is regarded as the criterion standard. Endoscopy and histologic findings are considered a method that can aid in the diagnosis of this entity.The aim of this study was to describe the histopathologic findings in children suspected of cow's milk protein allergy that were seen at our hospital.A descriptive, observational study was conducted on 116 children clinically suspected of presenting with cow's milk protein allergy that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría. Upper endoscopy and rectosigmoidoscopy with biopsies were performed and the findings were described.Of the 116 patients, 64 (55.17%) were girls and 52 (44.83%) were boys. The rectum was the site with the greatest presence of eosinophils per field in both groups, followed by the duodenum. In general, more than 15 eosinophils were found in 46% of the patients.Between 40 and 45% of the cases had the histologic criterion of more than 15 to 20 eosinophils per field and the rectosigmoid colon was the most affected site. Therefore, panendoscopy and rectosigmoidoscopy with biopsy and eosinophil count are suggested.