Is gastric nodularity a sign for gastric inflammation associated with Helicobacter pylori infection in children?

The aim of this study was to investigate the accuracy of using gastric nodularity (GN) as a marker for gastric inflammation associated with Helicobacter pylori infection in children. A retrospective analysis of 395 upper endoscopies done in children between 1990-1996 was performed. Demographics, clinical symptoms, endoscopic features, rapid urease test (RUT), and histological results were collected from each report. GN was found in 13 (3.5%) children. GN showed a significant correlation with age but not with gender. Multiple regression analysis showed a significant correlation between GN and gastritis with RUT but not with other histological determinants alone (gastritis, RUT, or H. pylori organisms). Nevertheless, GN had a poor accuracy rate to determine H. pylori-associated gastritis (sensitivity, 61%; positive predictive value, 12%). GN is a poor predictor for gastric inflammation associated with H. pylori infection in children. During endoscopy, gastric biopsies should always be obtained in children to establish the presence of mucosal inflammation.