Place du traitement chirurgical au cours de la maladie de Crohn de l'enfant et de l'adolescent (à propos de 54 patients (1982-2006)

Le principal facteur de gravité de la maladie de Crohn chez l'enfant et l'adolescent est son retentissement sur la croissance staturo-pondérale et le développement pubertaire dont la surveillance est l'un des éléments indispensables pour apprécier l'activité de la maladie et l'efficacité des traitements mis en œuvre. Le but de ce travail était d'évaluer l'effet d'une chirurgie d'exérèse ou de dérivation digestive, dans une population d'enfants atteints de maladie de Crohn, sur la croissance, le développement pubertaire et la corticodépendance. Notre travail a permis de confirmer l'effet bénéfique de la chirurgie sur ces paramètres avec reprise de la croissance staturale, diminution de la corticodépendance et amélioration de l'état général et de la qualité de vie après le geste chirurgical. La chirurgie est d'autant plus efficace sur la croissance qu'elle est effectuée tôt dans l'évolution de la maldie et particulièrement avant ou au début de la période pubertaire.GRENOBLE1-BU Médecine pharm. (385162101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Feeding disorders in children with oesophageal atresia: a cross-sectional study

International audienceIntroduction With advances in surgical and neonatal care, the survival of patients with oesophageal atresia (OA) has improved over time. Whereas a number of OA-related conditions (delayed primary anastomosis, anastomotic stricture and oesophageal dysmotility) may have an impact on feeding development and although children with OA experience several oral aversive events, paediatric feeding disorders (PFD) remain poorly described in this population. The primary aim of our study was to describe PFD in children born with OA, using a standardised scale. The secondary aim was to determine conditions associated with PFD. Methods The Feeding Disorders in Children with Oesophageal Atresia Study is a national cohort study based on the OA registry from the French National Network. Parents of children born with OA between 2013 and 2016 in one of the 22 participating centres were asked to complete the French version of the Montreal Children’s Hospital Feeding Scale. Results Of the 248 eligible children, 145 children, with a median age of 2.3 years (Q1–Q3 1.8–2.9, min–max 1.1–4.0 years), were included. Sixty-one children (42%) developed PFD; 13% were tube-fed (n=19). Almost 40% of children with PFD failed to thrive (n=23). The presence of chronic respiratory symptoms was associated with the development of PFD. Ten children with PFD (16%) had no other condition or OA-related complication. Conclusion PFD are common in children with OA, and there is no typical profile of patients at risk of PFD. Therefore, all children with OA require a systematic screening for PFD that could improve the care and outcomes of patients, especially in terms of growth