Page 225 - Abstract Book KONIKA 18

Gastroenterohepatology

P-GEH-030
Relationship between Gastrointestinal Symptoms and Antiepileptic Drugs
in Pediatric Patients with Epilepsy

Hanum Ferdian, Evi Rokhayati, Rekno Widati, Bambang Soebagyo
Department of Child Health, Faculty of Medicine Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakar-
ta, Central Java, Indonesia

Abstract
Background Epilepsy is commonly found during the first year of life. Epilepsy could have up to hundreds
of spasmic attacks daily, requiring anticonvulsants use. Long-term antiepileptic (AE) drugs administration
is rarely without its side effects. The most common prescribed drug for pediatric patients with epilepsy were
phenytoin and valproic acid. Objective To investigate the relationship between gastrointestinal symptoms
and antiepileptic drugs in pediatric patients with epilepsy. Methods This was a retrospective study with 26
total pediatric patients with epilepsy were enrolled from January 2019 to December 2020 in dr. Moewardi
General Hospital. The correlation test used contingency coefficient test. Results The subject had a mean of
6.50 (SD 3.29) months for age and 19.78 (SD 8.73) for weight. From the population, 61.5% were male and
76.9% took valproic acid. All reported GI symptoms, the most common being lower GI tract problems without
upper GI tract involvement (42.3%). No significance was found among the patients’ general characteristics
and AE drugs administration duration towards GI symptoms. However, a significant relationship between
types of AE drugs, in which valproic acid was associated with a higher number of upper and lower GI tract
symptoms (P=0.014). Conclusions Antiepileptic drugs seems to affect gastrointestinal tract problem, and
valproic acid has higher number of GI tract problem than phenytoin.
Keywords: anti-epileptic drugs; gastrointestinal symptoms; pediatric; phenytoin; valproic acid

P-GEH-031
Pyloric Stricture due to Caustic Injury in Teenager: A Case Report

Dara Indira Diniarti, Pramita G Dwipoerwantoro
Child Health Department, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital,
Jakarta, Indonesia

Abstract
Background Caustic injury is an important problem with great morbidity. An estimated 5.000 – 15.000 cases/
year occur in United States. Caustic agents are strong acid (pH< 3) or alkali (pH>11) which cause serious
injuries and long-term complications. Series of endoscopic procedures showed as safe and effective for
caustic injury management. Objective To demonstrate series of endoscopic procedures for pyloric stricture
management Case A 14 years old girl came to Cipto Mangunkusumo Hospital with recurrent vomiting,
nausea, and weight loss since strong acid ingestion accidentally 7 months prior to admission. Barium meal
evaluation showed gaster dilation and stenosis of pyloric region. Esophagogastroduodenoscopy (EGD)
showed severe esophagitis, multiple esophageal ulcers, erosive gastritis, anthral fibrotic, pyloric stricture
(<3 mm), and laryngo-pharyngeal-reflux (LPR). The endoscopic balloon dilation (EBD) was done with
Wilson-Cook dilator 12-14 mm. The patient got total parenteral nutrition (TPN), cefotaxime, esomeprazole,
and dexamethasone intravenous for 3 days then continue with oral omeprazole routinely and diet modification.
The patient undergoes 8 EGD evaluation, 3 EBD series, and 1 Endoscopic Incisional Therapy (EIT) for
pyloric web. The 9 EGD showed improving esophageal and gastric mucosal ulcer, fibrotic, and septation.
th
Diameter of pyloric lumen was 14 mm with an improving pyloric web. This patient shows improving clinical
symptoms, weight gain, and acceptable tolerance for solid food. There was no perforation, infection, or
malignancy development during 2 years of monitoring. Conclusion The endoscopic procedures remain safe
and effective for management of caustic injury complications. Long-term monitoring is needed for evaluation.
Keywords: caustic injury; acid ingestion; pyloric stricture; endoscopic dilation

KONIKA XVIII Abstract Book 177