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August 1997

Pathological Case of the Month: Helicobacter pylori Gastritis

Author Affiliations

From the Departments of Pediatrics (Dr Shetty) and Pathology (Dr Correa), and Division of Gastroenterology and Nutrition (Drs Udall and Schmidt-Sommerfeld), Louisiana State University Medical Center, New Orleans.

Arch Pediatr Adolesc Med. 1997;151(8):855-856. doi:10.1001/archpedi.1997.02170450105020

A 10-YEAR-OLD white boy was referred to a pediatric gastroenterologist for evaluation of recurrent epigastric pain and symptoms of gastroesophageal reflux. The results of the physical examination were unremarkable. His height and weight were both above the 95th percentile. Results of a complete blood cell count were normal. A radiographic series of the upper gastrointestinal tract was unremarkable. A 24-hour pH-probe monitoring of the lower esophagus showed gastroesophageal reflux. Endoscopic findings of the upper gastrointestinal tract revealed nodular antral gastritis (Figure 1). In addition, small duodenal ulcer and a gliding hiatal hernia were noted. Biopsy specimens from the gastric antrum were obtained (Figure 2 and Figure 3).

Diagnosis and Discussion

Helicobacter pylori Gastritis

Helicobacter pylori colonizes the gastric mucosa and is a major cause of chronic gastritis in both adults and children.1,2 Furthermore, a causal relationship between H pylori and peptic ulcer disease is suggested by the presence of