Table of Contents

HK J Paediatr (New Series)
Vol 8. No. 4, 2003

HK J Paediatr (New Series) 2003;8:336-340

Original Article

Inflammatory Bowel Disease in Hong Kong Chinese Children: A 10-year Experience in a University Hospital
香港華人兒童的炎性腸病:大學醫院的 10 年經驗總結

YH Tam, KF To, D Lau, KH Lee, CK Yeung


Crohn's disease (CD) and ulcerative colitis (UC), that are collectively known as inflammatory bowel disease (IBD), are uncommonly seen in Asian paediatric population. We have retrospectively reviewed paediatric IBD patients managed in our hospital in the last 10 years. Methods: Retrospective review of patients diagnosed to have IBD before the age of 15 with focus on clinical presentations and outcomes. Results: 7 CD and 2 UC patients were identified. Mean age of onset of symptoms for CD was 10.7 years while the 2 UC patients presented at 33 months and 10 years old respectively. Mean time interval between onset of symptoms and diagnosis made was 20.4 months. Two CD patients were misdiagnosed to have TB colitis initially. Pathology patterns for CD were isolated small bowel disease in 2/7, isolated colonic disease in 1/7 and 4/7 with both terminal ileum and colon involvement. Two UC patients had proximal extent of involvement to descending and transverse colon respectively. Anaemia, thrombocytosis, high ESR and hypoalbuminaemia were the most consistently abnormal biochemical results at presentation. 8/9 patients had remission of symptoms at 3 months after medical therapy. One CD patient underwent surgical intervention because of failure of medical treatment and growth failure. In majority of patients the disease ran a chronic intermittent course. Two patients were complicated with psychiatric disorders requiring specific therapy. Conclusions: IBD is an uncommon disease in our paediatric population and delay in diagnosis has been significant. Accumulation of experience and high index of suspicion improve the diagnosis. Management strategy should include medical, surgical and psychosocial aspects.

大學教學醫院兒童發炎性腸道疾病 10 年經驗回顧,克隆氏病及潰瘍性結腸炎是眾所周知的發炎性腸道疾病,然而其在亞洲兒童中並不常見。我們對過去 10 年間我們醫院患發炎性腸道疾病的患兒進行了回顧。方法:對 15 歲以下診斷為發炎性腸道疾病的患兒其臨床表現及治療效果進行回顧總結。結果:共有 7 名克隆氏病患兒及 2 名潰瘍性結腸炎患兒,症狀出現的平均年齡在克隆氏病患兒為 10.7 歲,在 2 名潰瘍性結腸炎患兒分別為 33 個月及 10 歲。從出現症狀至確診的平均時間為 20.4 個月。2 名克隆氏病患兒原被誤診為結核性結腸炎。病理分型顯示在 7 名克隆氏病患兒中,2 名病發在小腸,1 名病發在結腸,4 名病發在遠端回腸及結腸。2 名潰瘍性結腸炎患兒分別病發在升結腸及橫結腸。相應的異常生化結果表現為貧血,血小板增加,高 ESR 和低蛋白血症。9 名患兒中 8 名在接受藥物治療後 3 個月症狀消失。1 名克隆氏病患兒因藥物治療失敗且影響正常生長發育而接受了外科治療。大多數病人病程緩慢且間歇發作。2 名病人因精神失常而需特殊治療。結論:發炎性腸道疾病在香港兒童中並不普遍,且確診明顯延遲。經驗的積累和高度懷疑措証可改善診斷。治療應包括藥物、外科手術及心理治療。

Keyword : Children; Chinese; Inflammatory bowel disease



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