Abdominal pain is a common and recurring problem in paediatric emergency departments.

AIM: Abdominal pain is a frequent reason for paediatric emergency department visits, but specific research is lacking. Our aim was to obtain information on the diagnosis of abdominal pain and what healthcare services children with this condition need. METHODS: This retrospective study focused on patients visiting the emergency department of the Children's Hospital Iceland in 2010 with abdominal pain and any subsequent visits up to 1 January 2015. RESULTS: There were 11 340 visits to the emergency department in 2010 and 1118 children made 1414 (12%) visits due to abdominal pain. The majority (58%) with abdominal pain were girls (p < 0.001) and they were older than the boys, with an average age of 12 versus 10 years (p < 0.001). The most common diagnoses were non-specific abdominal pain (40%), constipation (22%) and viral infections (13%). During the follow-up period, 423/1118 children (38%) visited the emergency department 883 times, 58% were girls and the most common diagnosis was non-specific abdominal pain (37%). Of the 436 children initially diagnosed with non-specific abdominal pain, 154 (35%) revisited the emergency department during the follow-up period. CONCLUSION: Abdominal pain was a common reason for visits to the paediatric emergency room and a third paid more than one visit.

Inflammatory bowel disease in Icelandic children 1951-2010. Population-based study involving one nation over six decades.

AIM AND BACKGROUND. We describe the changes in incidence and disease location of inflammatory bowel disease (IBD) in children in one country over six decades. Iceland is an island with centralized health information. Children with IBD are cared for in only two hospitals. Iceland is therefore well suited for nationwide epidemiologic studies. MATERIAL AND METHODS. All IBD patients 16 years and younger diagnosed in Iceland from 1950-2010 were included. Patients were identified retrospectively from 1950-1989, and prospectively from 1990-2010, by reviewing pathology and charts for all patients diagnosed with IBD. Criteria for the diagnosis of ulcerative colitis (UC) were history of blood in stools for >3 weeks, characteristic endoscopic appearance of continuous inflammation of the colon, and histologic appearance of acute and chronic inflammation of the colon without granulomata. Criteria of Crohn's disease (CD) were history of abdominal pain, blood in stools, and endoscopic, radiologic, and histologic features of CD. RESULTS. One hundred and ten children were diagnosed with IBD, 61 with UC, 44 with CD, and 5 with indeterminate disease. The median age was 13.7 ± 2.6, with sex distribution varying from decade to decade. From 1980 until 2000, there was a dramatic increase in the incidence of IBD from 1.2 per 100,000 children <16 years of age to 5.6 per 100,000. However, in the past decade, the incidence has plateaued. CONCLUSION. In this population-based pediatric study, we report an increase in the incidence of IBD from 1950-2000. Incidence in Icelandic children is lower than in published studies from other Northern European countries.

[Eosinophilic esophagitis in children. Two case reports]. / Raudkyrningabólga í vélinda í börnum. Tvö sjúkratilfelli.

Eosiniophilic Esophagitis (EoE) is a relatively new disease which was first reported in 1978 but increasingly diagnosed in the last 15 years. Initially EoE was mainly described in children but later also recognized in adults. In infants it presents as a food refusal, failure to thrive and vomiting. In older children and adults symptoms include chest pain dysphagia, oesophageal food impaction and even strictures on endoscopy. The etiology of EoE is often food allergy. Diagnosis is made on biopsies from the oesophagus and by excluding other causes of eosophageal eosinophilia. It is treated by eliminating the offending food groups or using local corticosteroids. We describe different presentation of eosinophilic esophagitis in two children and discuss diagnosis and treatment.

[Effect of Pentavac and MMR vaccination on the intestine.].

OBJECTIVE: The safety of infant vaccination has been questioned in recent years. In particular it has been suggested that the measles, mumps and rubella (MMR) vaccination leads to brain damage manifesting as autism consequent to the development of an "enterocolitis" in the immediate post-vaccination period. AIM: To assess if MMR vaccination is associated with sub-clinical intestinal inflammation which is central to the autistic "enterocolitis" theory. The study was not designed to test directly the association of autism to MMR vaccination. MATERIAL AND METHODS: We studied 109/20 infants, before and two and four weeks after immunization with Pentavac and MMR vaccines, for the presence of intestinal inflammation (faecal calprotectin). RESULTS: Neither vaccination was associated with any significant increase in faecal calprotectin concentrations. CONCLUSIONS: The failure of the MMR vaccination to cause an intestinal inflammatory response provides evidence against the proposed gut-brain interaction that is central to the autistic "enterocolitis" hypothesis.