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Archives of Pediatric Gastroenterology, Hepatology, and Nutrition
Published by Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition
ISSN : -     EISSN : 28305442     DOI : -
Core Subject : Health,
Medicine & Pharmacology
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition (APGHN) is the official journal issued by the Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (Perhimpunan Gastroenterologi, Hepatologi, dan Nutrisi Anak Indonesia). APGHN is issued four times in a year and published in English. Previously published in print form as Jurnal Gastrohepatologi Anak Indonesia (JGAI), APGHN is committed to promote scientific development in child’s health through high-quality publication and provides recent updates on pediatric gastroenterology, hepatology, and nutrition for health practitioners and scholars. APGHN accepts original articles, case reports, review articles, medical illustrations and clinical practice guidelines, all of which have been peer-reviewed carefully by our selected experts.
Arjuna Subject : Kedokteran - Pediatrics, Perinatology, and Child Health
Articles 44 Documents
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Pancreatic Stones in Children with Chronic Pancreatitis: A Case Report Nicodemus Nicodemus; Nuraini Irma Susanti
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 1 No. 3 (2022): APGHN Vol. 1 No. 3 November 2022
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (285.441 KB) | DOI: 10.58427/apghn.1.3.2022.15-22

Abstract

Background: Chronic pancreatitis is a continuous progressive inflammation of the pancreas that can cause recurrent abdominal pain. The incidence of chronic pancreatitis in children is on an upward trend in recent years. The purpose of this case report is to enhance clinician's insight in considering chronic pancreatitis as a differential diagnosis in cases of recurrent abdominal pain in children. Case: We reported a case of chronic pancreatitis with pancreatic stones in a 12-year-old child. The patient came with complaints of recurrent upper left abdominal and heartburn accompanied by nausea and vomiting. Epigastric and left hypochondriac tenderness were found. Laboratory examination showed an increase in pancreatic enzymes up to 6x the normal value. The results of abdominal CT-scan and MRCP showed multiple pancreatic stones with pseudocysts. The patient then underwent the Puestow procedure. Postoperatively, the complaints of abdominal pain resolved and the pancreatic enzymes improved significantly. Discussion: The diagnosis of pancreatitis must meet 2 out of the 3 criteria that have been determined. Primary management includes fluids, analgesics, early nutrition, and surgery in cases of chronic pancreatitis accompanied by complications such as pseudocysts or pancreatic stones. Conclusion: This case teaches the need for a careful clinical approach and consideration of chronic pancreatitis as a differential diagnosis in a child with recurrent abdominal pain.
Correlation of Increased Serum Ferritin with SGOT, SGPT, and Albumin Levels in Children with β-Thalassemia Major Cut Nanda Feby Ayulinda; Sulaiman Yusuf; Heru Noviat Herdata; Darnifayanti; Syafruddin Haris; Bakhtiar
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 1 No. 3 (2022): APGHN Vol. 1 No. 3 November 2022
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (231.841 KB) | DOI: 10.58427/apghn.1.3.2022.1-7

Abstract

Background: Routine transfusion in β-thalassemia major children will cause excess iron in organs, especially the liver, as illustrated by the serum ferritin value. Excess iron in the liver can cause disturbances in liver enzymes and liver function, which can be assessed using SGOT, SGPT, and albumin examination parameters. This study intends to assess the relationship between increased serum ferritin levels with SGOT, SGPT, and albumin levels in β-thalassemia major children. Methods: This is an observational cross-sectional study which was conducted at the dr. Zainoel Abidin Hospital in Banda Aceh. Research subjects underwent examination of serum ferritin, SGOT, SGPT, and albumin. Results: A total of 37 β-thalassemia major children between 1 until <18 years of age were included in this study. The mean serum ferritin, SGOT, SGPT and albumin levels in β-thalassemia major patients were 4596 ± 2750.07 ng/mL, 57.32 ± 44.20 U/L, 57.46 ± 54.77 U/L, and 4.34 ± 0.22 g/dL respectively. The correlation coefficient between ferritin levels and SGOT was 0.768 (p-value <0.05). While, the correlation coefficient between ferritin and SGPT levels was 0.708 (p-value < 0.05). On the other hand, the correlation value between ferritin and albumin levels was -0.114 (p-value > 0.05). Conclusion: Increased serum ferritin levels in β-thalassemia major children are related to SGOT and SGPT levels. But there is no relationship between increased serum ferritin and albumin levels in β-thalassemia major children.
Bowel Preparation in Pediatric Colorectal Surgery, Can We Move On? Historical and Literature Review Kshetra Rinaldhy; Ganesha Wisnu; Ni Made Sarastri Widyani; Ahmad Yani
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 1 No. 3 (2022): APGHN Vol. 1 No. 3 November 2022
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (168.042 KB) | DOI: 10.58427/apghn.1.3.2022.29-35

Abstract

Background: Surgical procedure in colorectal cases have a high morbidity rate; in pediatric population, surgical site infection occurs in more than 13% of patients undergoing elective colorectal surgery. Bowel preparation is believed to decrease infection rate by removing feces from colorectal. This procedure has been routinely performed despite the lack of clear evidence and the invasive nature of the procedure. In pediatric population, the evidence is scarce with varying qualities, thus this study aims to evaluate the effect of bowel preparation on pediatric population. Methods: We conducted a comprehensive literature review from PubMed and cross-referencing articles. Six full-text studies presenting bowel preparation in pediatric colorectal surgeries were included in the analysis. Results: Majority of studies we analyzed showed no association between bowel preparation and surgical site infections. They also showed the lack of correlation between the procedure and post-operative complication. Discussion: Bowel preparation was quickly adapted by surgeons due to its theoretical effect, but current evidence showed no clear benefit in doing so. In pediatric cases, the evidence is scarce and variable, and with the risk associated, surgeons should consider carefully before conducting bowel preparation in pediatric patients.  Conclusion: Bowel preparation does not significantly decrease post-operative morbidities, such as anastomosis leakage, intrabdominal infection, and surgical wound infection.
Early Exposure of Antibiotic as A Risk Factor for Gastrointestinal Disorders: An Evidence-Based Case Report Ezy Barnita; Lukito Ongko; Muzal Kadim
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 1 No. 3 (2022): APGHN Vol. 1 No. 3 November 2022
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (214.797 KB) | DOI: 10.58427/apghn.1.3.2022.23-8

Abstract

Background: Incidence rate of pediatric onset inflammatory bowel disease (IBD) has been increasing worldwide particularly in the rapidly growing countries. It has been hypothesized that environmental factors such as method of delivery, rural or urban living environment and the use of antibiotics, may play significant roles. Antibiotics are known to alter gut microbiome and henceforth may be the rational mechanism in the development of gastrointestinal autoimmune diseases. Methods: Literature search was performed on 3 international databases (PubMed, PubMed PICO and Google Scholar) by using relevant keywords based on clinical question. Results: Two systematic reviews were included in this study. Both studies reported strong evidence regarding the increase risk of occurrence for inflammatory bowel disease and celiac disease after exposure of antibiotics particularly in young age Discussion: At young age, the immune system and gut microbiota is considered to be unstable and prone to disruption particularly by exposure of antibiotics. Antibiotics is known to weaken mucosal barrier of the gut which facilitates translocation of commensal bacteria. Translocation process together with the imbalance ratio of T-helper 1 and T-helper 2 may be the pathogenesis behind the development of chronic gastrointestinal diseases. Conclusion: There is strong evidence that early life exposure to antibiotic is associated with the development of IBD and Celiac disease in childhood. Therefore, it is critical for all healthcare workers to adhere to strict guidelines regarding the rationality on when to prescribe antibiotics particularly in children of young age.
Clinical Profile of Constipation in Children Under 5 Years of Age in Dr. Soetomo General Academic Hospital, Indonesia Steven Christian Susianto; Vina Lidya Setjaputra; Alpha Fardah Athiyyah; Khadijah Rizky Sumitro; Andy Darma; Reza Gunadi Ranuh; Subijanto Marto Sudarmo
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 1 No. 3 (2022): APGHN Vol. 1 No. 3 November 2022
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (196.798 KB) | DOI: 10.58427/apghn.1.3.2022.8-14

Abstract

Background: Childhood constipation is still common among children under 5 years of age. This study was conducted to determine the clinical profile of childhood constipation under 5 years of age at dr. Soetomo General Hospital, Indonesia. Methods: This retrospective cross-sectional study was performed by reviewing medical record of constipated children under 5 years of age at dr. Soetomo General Hospital Surabaya from January to December 2021. Data regarding age, gender, living place, body anthropometric (weight, height and nutritional status), sign and symptoms, and physical examination were collected for each patient. Nutritional status was determined by using WHO 2006 growth chart. We also assessed the presence of concomitant disease among those children and presented the data on the table. Results: A total of 35 subjects with constipation were included in this study. Mean (±SD) for age, body weight, length/height of these subjects were 27.09±17.71 months, 10.93±6.11 kg, 82.34±18.52 cm, respectively, with the male and female ratio of 1,67: 1. Around 18.2% of subjects presented with wasted, 18.2% with severely wasted, and 18.2% with severely stunted. Hardened stool (80%) was the most prevalent symptom, followed by straining (37.1%) and fecal impaction (22.9%). The most common concomitant diseases of childhood constipation were Hirschsprung’s disease (17.1%), congenital heart disease (11.4%), and hypothyroidism (11.4%). Conclusion: The results of this study showed that boys had a higher prevalence of constipation in children under 5 years of age, with the most prevalent clinical features being hardened stool, straining, and fecal impaction. Meanwhile, Hirschsprung’s disease, hypothyroidism, and congenital heart disease were the most concomitant disease.
Pediatric Hepatitis A: A Case Report Sulaiman Yusuf; Fitri Mardia Sari Siregar
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 1 (2023): APGHN Vol. 2 No. 1 February 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.1.2023.27-31

Abstract

Background: Hepatitis A is a systemic infection which predominantly inflame the liver due to Hepatitis-A-Virus (HAV) infection. Developing countries have higher prevalence of this disease because of poor sanitation and environment. The transmission of HAV is fecal-oral via contaminated foods or beverages. Case: A 14-year-old boy visited emergency department with yellowish skin on body, nausea, fever, and liver enlargement. He had a bad habit of consuming unhealthy street-foods. Hepatitis A was diagnosed after history taking, physical examination and laboratory testing. Serology test was performed with positive Anti HAV IgM to confirm the disease. Liver enzymes, and bilirubin level were also increased in this patient. Discussion: The transmission of HAV is through fecal-oral via contaminated foods or beverages. This disease can be prevented by having good personal hygiene, avoiding contaminated food, with good access to clean water and environmental sanitation. Habit of consuming street foods is a risk factor of developing HAV infection. The clinical manifestation of HAV infection includes jaundice, nausea, decreased appetite, and vomiting. Conclusion: Diagnosis of hepatitis A requires careful history taking, physical examination and laboratory evaluation. Hepatitis A is a self-limiting disease and currently there is no specific treatment to cure this disease. Supportive treatment, hepato-protector and vitamin supplementation will improve the condition.
Liver Injury in Children with COVID-19: A Systematic Review Satrio Wibowo; Tita Luthfia Sari; Muhammad Irawan
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 1 (2023): APGHN Vol. 2 No. 1 February 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.1.2023.1-15

Abstract

Background: The rapid global spread of coronavirus disease 2019 (COVID-19) infection has become a major health issue with high morbidity and mortality rates. COVID-19 in children showed different unique presentations. Besides respiratory symptoms, a growing body of evidence indicates multi-organ manifestation, including liver involvement. In this regard, several data supported an association between COVID-19 infection and liver injury in adults, while on the other hand, there is compelling but currently limited evidence in children. In this systematic review, we summarize data of updated literature regarding the evidence of acute liver injury in children with COVID-19. Methods: Online scientific articles were explored on PubMed and Google Scholar databases using keywords. The systematic review was performed under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines Results: The literature search yielded 238 articles, of which 16 were identified as relevant to the topic and met the inclusion criteria. A total of 564 pediatric patients were confirmed positive for COVID-19 by PCR examination, involving 298 (52.9%) boys and 266 (47.1%) girls with an age range of 1 day - 17 years. Liver injuries have been reported in pediatric COVID-19 patients, with prevalence ranging from 1.5 to 52%. Conclusion: SARS-CoV-2 virus infection in children shows a unique presentation. Several reports suggest that liver injury correlates with the severity of COVID-19 disease. Therefore, monitoring liver function in COVID-19 patients is important to assess the prognosis.
Risk Factors Affecting the Length of Improvement of Nutritional Status in Children with Congenital Heart Disease and Malnutrition Athiyatul Aufie; Sukman Tulus Putra; Mulya Rahma Karyanti; Yoga Devaera
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 1 (2023): APGHN Vol. 2 No. 1 February 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.1.2023.16-26

Abstract

Background: To date, limited data are available regarding the factors that contribute to the delay of improvement in nutritional status as well as data regarding the optimal duration to improve malnutrition among children with congenital heart disease (CHD). Such data are important for pediatricians to fully optimize the nutritional status for those children prior to surgical procedure This study aims to identify those aforementioned factors in hope for better surgical outcome and quality of life of children with CHD. Methods: This is a descriptive analytic study using retrospective cohort design to identify the factors that contribute to the delay of improvement in nutritional status among children with CHD. Variables such as the type of CHD, classification of CHD complexity, pulmonary hypertension, heart failure, corrective surgery, the route of nutrition access, pneumonia, diarrhea, special diets and patients undergoing routine control at the nutrition outpatient clinic were evaluated in this study. Results: A total of 216 children with a diagnosis of CHD and weight-for-length z-score under -1 SD were included in this study. Based on multivariate analysis, there were two significant risk factors, which were the occurrence of diarrhea and consulting at nutrition outpatient clinic. The improvement in nutritional status in children with CHD who did not have diarrhea was faster than those with diarrhea (HR 1.94; 95% CI 1.10 – 3.47) (p value <0.025). Improvement in nutritional status of those children that underwent control at the nutrition outpatient clinic was faster than those who did not (HR 1.87; 95% CI 1.20 – 2.92) (p value <0.006). Conclusion: Risk factors that significantly lengthen the duration of improvement in the nutritional status of CHD patients were the incidence of diarrhea and those who did not undergo control at the nutrition outpatient clinic.
How to Interpret Liver Function Test in Daily Practice Yudith Setiati Ermaya; Dwi Prasetyo
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 1 (2023): APGHN Vol. 2 No. 1 February 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.1.2023.40-52

Abstract

Background: The liver is a multi-function organ that plays a role in producing various important secrete, synthesis and metabolic functions. The term liver function test is also used to refer to the hepatocyte synthesis function, such as serum albumin and prothrombin time. In this paper, we will discuss how to interpret various liver function test results in daily practice as well as approach to abnormal liver function tests. Discussion: Abnormal result of liver function test is frequently found in asymptomatic healthy patients who are undergoing routine screening. On the contrary, some patients with liver disease may appear with normal liver function test. As such, there are some limitations regarding this particular test. ALT (SGPT) is the primary marker of hepatocellular injury due to it being more sensitive and specific than AST (SGOT). Conjugated bilirubin level of more than 20% of total bilirubin level is a strong indication of hepato-biliary disease and is always pathogenic. GGT is only increased in cholestatic conditions and not in bone disease. As such, GGT levels can help to distinguish abnormalities in the liver or bones in conditions of increased ALP levels in the blood. Conclusion: Serum liver biochemistry examination is very useful and effective in assessing liver function. Understanding the proper interpretation of liver enzymes will help clinicians easier to diagnose or predict a disease as well as condition related to the liver in daily practice.
Duodenal Stenosis: A Case Report Cindy Gisella Zahrany; Farahdina Shahnaz; Muzal Kadim
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 1 (2023): APGHN Vol. 2 No. 1 February 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.1.2023.32-9

Abstract

Background: Congenital duodenal stenosis in pediatric patients was often underreported due to its non-conspicuous signs and symptoms. Diagnosing duodenal stenosis is often challenging as this disease causes partial intestinal obstruction and thus presents with more indolent and atypical clinical manifestations. This case report aims to describe the atypical case of pediatric duodenal stenosis which presented with recurrent vomiting and poor weight gain as well as highlight some of the diagnostic challenges. Case: A 7-month-old girl was admitted to the emergency room with chief complaint of recurrent vomiting in the last 2 days prior to hospital admission. Patient had a history of recurrent bilious vomiting at the age of 3 days old with a frequency of 3-4 times a day and were admitted to the hospital for 2 weeks. Parents also reported of poor weight gain in the last 3 months. Abdominal X-Ray series showed dilatation of the small intestines immediately after pylorus and stack of coins sign. Esophageal endoscopic evaluation showed signs of severe GERD with a pyloric gap as well as a suspicion of a duodenal web Discussion: Congenital obstruction at the duodenum may occurs due to intrinsic or extrinsic etiology. Failure of duodenal re-canalization during the 8-10th week of embryological development is thought to be the main cause of intrinsic duodenal obstruction (atresia, stenosis or duodenal web). The appearance of clinical manifestation of duodenal stenosis depends on the degree of stenosis itself. Conclusion: Congenital duodenal stenosis may present with atypical presentations in neonates which requires clinicians to be fully aware of this diagnosis to ensure timely therapy. The main management of duodenal stenosis is surgery, however fluid administration, decompressing as well as other supportive treatment are equally crucial to ensure better outcome for the patient.

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