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Acta Endoscopica

, Volume 24, Issue 2, pp 151–156 | Cite as

Gastroscopie chez le prématuré

  • T. Ruuska
Article

Résumé

Le développement des endoscopes de fin calibre a permis des gastroscopies chez des enfants prématurés de poids inférieur à 500 g. La gastroscopie avec un endoscope très maniable — Olympus GIF-N30 baby gastroscope (diamètre 5,2 mm) — s’est avérée une méthode d’exploration très sûre: la saturation en oxygène et la pression artérielle demeurent stables et on ne note qu’une légère accélération transitoire du pouls. L’exploration prospective des nouveaux-nés dans une unité néonatale de soins intensifs a montré que les enfants nés avant terme présentaient des ulcères gastriques de stress dans 25 % des cas, une gastrite hémorragique dans 25 % des cas et des lésions gastriques mineures chez 25 % des sujets examinés. Par conséquent, 25 % seulement des enfants prématurés ont une muqueuse gastrique intacte. La signification de ces altérations de la muqueuse gastrique chez les prématurés stressés reste peu claire mais on peut imaginer que ces lésions entraînent une anémie car le site de saignement constitue une voie d’entrée des bactéries et ces lésions prédisposent à un risque de perforation après utilisation de certains médicaments. C’est pourquoi le but final de la prise en charge des enfants dans une unité de soins intensifs est de garantir le maintien d’une muqueuse gastrique intacte. Les gastroscopies du prématuré réalisées, sur base d’indications sélectives, devraient permettre d’atteindre ce but.

Mots-clés

endoscopie gastrite gastroscopie hémorragies du tractus digestif supérieur prématurés ulcère 

Gastroscopies in preterms

Summary

Development of small caliber flexible endoscopes has enabled gastroscopies in preterm infants weighing no more than 500 grams. Gastroscopy with very gentle handling of Olympus GIF-N30 baby gastroscope (diameter 5.2 mm) has proved to be a safe procedure: Oxygen saturation and blood pressure remain steady, and there is only a slight transient increase in the pulse rate. Prospective screening of neonates treated in neonatal intensive care unit has shown that preterm infants have stress-induced gastric ulcers in 25 %, hemorrhagic gastritis in 25 %, and mild gastric lesions in 25 % of cases. Only 25 % of premature infants have intact gastric mucosa. The full significance of gastric mucosal damage in preterms under stress is not yet clear, but one might assume that the lesions may cause anemia because of bleeding form an entry port for bacteria, and be associated with the risk of perforation following use of certain drugs. Therefore, the ultimate goal of management of infants in intensive care ought to be maintenance of an intact gastric mucosa. Gastroscopies of preterm infants, performed for selected indications, will contribute to achieving this goal.

Key-words

endoscopy gastritis gastroscopy preterm ulcer upper G.I. bleeding 

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Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • T. Ruuska
    • 1
    • 2
  1. 1.Department of PediatricsTampere University HospitalTampereFinland
  2. 2.Department of Clinical MedicineTampere UniversityTampereFinland

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