Pediatric Gastroenterology & Hepatology Service (PGE/HS)

Pediatric gastroenterology and hepatology service (PGE/HS) was founded in 2004 after joining Republican Children’s Hospital to “Arabkir” MC. However we have been collaborated with surgical department of “Arabkir” MC in the field of Portal Hypertension (PH) and liver diseases since 1995.

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PGE/HS provides inpatient (in different departments of of “Arabkir” MC) and outpatient activities – follow-up in dispensary (in the frame of beneficial package of MoH of RA) as well as primary outpatients (ambulatory) consultations and treatment of children up to the age of 18.

Main fields

  • Inflammation of the stomach, duodenum and peptic ulcer disease
  • Gastro esophageal reflux disease
  • Inflammatory Bowel Disease (Ulcerative colitis, Crohn’s disease, undetermined colitis)
  • Failure to thrive/ Malabsorbtion /
  • Celiac disease
  • Functional Gastrointestinal Disorders
  • Constipation (functional and organic), fecal soiling
  • Neonatal cholestasis
  • Congenital anomalies of the GI tract, liver and biliary tract (in collaboration with Surgery service)
  • Gall-stone disease ( in collaboration with Surgery service)
  • Autoimmune liver disease
  • Liver cirrhosis, portal hypertension, liver failure
  • Extra-intra hepatic portal hypertension (detection, preventive/therapeutic endosclerotherapy, porto-systemic shunting (in collaboration with Surgery service)

Complicated cases are discussing with foreign specialists and partners.

Distribution of outpatients according to diseases 

  • Disease Number of patients
    Chronic gastritis, duodenitis 20
    Peptic ulcer disease 14
    GERD 4
    Constipation 6
    Inflammatory bowel disease

    Ulcerative colitis

    Crohn’s disease

    IBD-unclassified

    Eosinophilic colitis

    47

    19

    5

    19

    5

    Portal hypertension (PH) 7
    Diseases of the liver and bile ducts

    Congenital anomalies

    Gall-stone disease

    Cholecystitis

    16

    10

    5

    1

    Autoimmune liver disease (hepatitis) 11
    Other liver diseases 7
    Polyposis of the Large bowel 1
    Celiac disease 11
    Recurrent Pancreatitis 1
    Total number of patients 145

    Current activities:

In-patient:

  • Hospitalization, consultations, management and treatment of with pediatric gastroenterological and liver diseases in Department of General pediatrics as well as infant’s and other pediatric departments of “Arabkir” MC-ICAH
  • Management and treatment of patients with PH (with Department of Surgery): endoscopic sclerotherpy, porto-systemic shunting, partial splenectomy, surgical correction of biliary tract anomalies (several operations were performed with assistance of foreign partners – surgeons from Europe and Russia).

Out-patient:

  • Long-term follow-up of patients with chronic GE/H disorders with clinical and laboratory evaluation and treatment up to 18 years of age in accordance with beneficial package of MoH of RA (medical consultation and investigations 3-4 times a year).
  • Consulting and treatment of the primary outpatients

Special investigations:

  • Routine clinical, biochemical, microbiological laboratory investigations of blood, urine and stools.
    • Diagnostics of Celiac disease: tissue transglutaminase IgA (t-TGA)
    • Diagnostics of Helicobacter pylori: Stool antigen test
    • Evaluation of excretory function of the pancreas: Stool elastase test
    • Evaluation of bowel inflammation: Stool Calprotectine test
  • Endoscopy
    • Upper and lower diagnostic endoscopy with biopsies, rapid Helicobacter Pyloris test
    • Preventive and therapeutic endoscopic scelrotherapy (also in case of esophageal and or/ GI bleeding)
    • Endoscopic polypectomy
  • Biopsy
    • Biopsy of the GI tract (forceps and capsule)
    • Liver biopsy

Histological investigation: histological investigation of the specimens in the appropriate laboratories

  • Radiological investigations
    • Ultrasound scan of the abdomen
    • Duplex scan of vessels of the portal vein
    • Radiological investigations of the GI tract: X-ray, with fluid as well as other (barium, air) contrasts.
    • CT scan
  • Sphyncterotonometry – manometry of anal sphincter (modified).

Our activities

Educational, methodological, organizational activities:

  • Publication of educational materials – for pediatricians, pediatric. gastroenterologists, family doctors and residents
  • Brochures, handouts
  • Malabsorption syndrome in children (2007 in Armenian and Russian)
  • Coeliac disease (2008) in Armenian;
  • Gastroesophageal reflux and gastroesophageal reflux disease in children (2010) in Armenian
  • Constipation in children (2011) in Armenian
  • Guidelines for internal use (diseases of the stomach and duodenum; inflammatory bowel disease; gastroesophageal reflux / gastroesophageal reflux;), 2014; 2015.
  • Discussions of topics and complicated cases with partners from Swiss, Belgium, USA (in the framework of long-term Intrenational Projects of Arabkir MC)
  • Regular visits to the regions of Armenia (lectures, seminars)
  • Organization of work-shops, seminars, conferences in «Arabkir» MC –ICAH in the framework of Association of Pediatrician of Armenia
  • Lectures, seminars with interactive discussions of topics and cases for YSMU students

Organizational activities

  • 2001-2006 Annual GI seminars and meetings for pediatricians, family doctors, residents have been organized. Guest faculty- Prof. David Shmerling (emeritus head of the Gastroenterology Department of University Children’s Hospital, Zurich, Switzerland) (“Arabkir” MC – ICAH)
  • July 2007: ESPGHAN Summer School (European Society of Pediatric Gastroenterology, Hepatologyand Nutrition), (“Arabkir” MC- ICAH)
  • November 2009: “Liver Diseases: Medical and Surgical Issues” International Armenian – Belgian conference; Guests Faculty: P. Michielsen & T.Chapelle, University  Hospital, of Antwerp, Belgium (“Arabkir” MC – ICAH).
  • September 2013: “Liver Diseases: Clinical and Pathological Issues” Armenian – Belgian International conference; (“Arabkir” MC – ICAH). Guests Faculty: P. Michielsen Driessen A., Els Van de Vijver, University  Hospital, of Antwerp, Belgium (“Arabkir” MC – ICAH) (in the framework of long-term International Projects of Arabkir MC)
  • October 2013: “Pediatric Gastroenterological and Infectious diseases Armenian – Swiss International Conference and Work-shop. Guest Faculty:  Professor Christian Braegger, Head of Paediatric Gastroenterology & Nutrition Department; Zurich University Children’s Hospital (in collaboration with Armenian Pediatric Association) (“Arabkir” MC – ICAH). (in the framework of long-term Intrenational Projects of Arabkir MC)
  • April 2015: Armenian – Swiss Pediatric Gastroenterological School and Conference Guest Faculty: Professor Christian Braegger, Head of Paediatric Gastroenterology & Nutrition Department; Zurich University Children’s Hospital (in collaboration with Armenian Pediatric Association) (“Arabkir” MC – ICAH). (in the framework of long-term Intrenational Projects of Arabkir MC)
  • Regular visits to the regions of Armenia and Republic of Nagorni-Karabakh: lectures, seminars for medical personal, consultations of GI/H patients.

Scientific activities

  • Inflammatory bowel disease (IBD), particularly coincidence of IBD and Familial Mediterranean Fever (FMF):
  • pylori associated inflammation of the stomach, duodenum, and particularly antibiotic resistance.
  • Portal hypertension and its complications
  • Publication of abstracts, articles and participation in international congresses and conferences
  • Defence of scientific thesis

Hepatological activities of surgical service of the «Arabkir» MC-ICAH:

  • In 2001-2009 with initiative of scientific director of «Arabkir» MC-ICAH Prof. Babloyan A.A. and active participation of the Head of Uro-surgery service Associate professor Arakelyan S.A. and the Head of G/H service Prof. Amaryan G.G. and Endoscopist Danielyan R.A. were organized diagnostics and conservative and surgical management and treatment of vascular anomalies of the GI tract, portal hypertension (preventive and therapeutic endosclerotherapy; porto-systemic shunting), as well as operations in patients with bile-duct anomalies. It was organized in close collaboration with surgeons from Belgium (prof. D. Eisebart, T, Chapel) and Russia (V. Senyakovich). Since 2006 the Head of the uro-surgical department Dr. P.A. Geyikyan has been also involved in above mentioned activities. Currently he is following up patients with Portal hypertension at the GE/H out-patient clinic.
  • From 2009-2010 with participation of foreign collaborators operations of partial splenectomy have been were performed, percutaneous liver biopsies were started.

Collaboration with

  • GI departments of other children’s hospitals in Yerevan.
  • Number of European pediatric hospitals:
    • Zurich University Children’s Hospital, Switzerland
    • University Hospital of Antwerp, Belgium
    • Scientific Institute of the Children’s Health of Russian Federation, Moscow
  • During 2001-2006 Prof. D. Shmerling – emeritus head of the Gastroenterology Department of University Children’s Hospital, Zurich, Switzerland). Had an active participation in organization of annual GI seminars and meetings for pediatricians, family doctors, residents.
  • Since 2009 Prof. P. Michelsene – head of the Hepatology Department of the Antwerp University Hospital joined to the Armenian – Belgian cooperation program and had an active participation in organization of conferences in Yerevan (2009, 2013) and in establishment of suction liver biopsy.
  • Since 2013 Prof. Ch. Braegger – head of the Gastroenterology, Hepatology and Nutrition Department of the University Children’s Hospital, Zurich, Switzerland joined to the Armenian – Swiss partnership project and had an active participation in organization of conferences and work-shops, seminars in Yerevan (2013) and in improvement of endoscopy unit activity

Our staff :

Gayane Amaryan

Gayane AmaryanMD, PhD, Dr. Sci ; Head of the gastroenetrology & hepatology service of “Arabkir MC” – ICAH. Prof. of  the Department of Pediatrics N 2 of the YSMU. Full member of ESPGHAN

Passed trainings in New-York Cornell University Medical Centre (1996, USA), Necker-Enfant Malade Hospital (2000, France), Salzburg (2004, 2015 Austria), Graz Pediatric University Hospital (2008, Austria); Zurich University Children’s hospital (Swiss, 2013).

Scientific interests: IBD, FMF (abdominal and digestive system manifestations).  Helicobacter pylori-associated gastroduodenal disease. Liver diseases / Portal hypertension.

Tel. (+37410) 262130; 236 883, ext. 1213, 2115, 1216

Tatevik Shahinyan

Tatevik Shahinyan MD, Pediatric gastroenterologist of “Arabkir MC” – ICAH.

Passed trainings in Graz Pediatric University Hospital (Austria, 2006); King’s College Hospital (London, 2007), Zurich University Children’s Hospital (Switzerland, 2007 and 2008), L’hopital Universitaire des Enfants Reine Fabiola, Brussels, Belgium (2009-2010).

Scientific interests: Inborn metabolic diseases, Helicobacter pylori-associated gastrodudenal disease, IBD

Tel. (+37410) 262130; 236 883, ext. 2115, 1216, 1181

Ruben Danielyan Ruben Danielyan MD, endoscopist of “Arabkir MC” – ICAH. Annualy performs ~ 700 endoscopy investigations/manipulations (upper/lower endoscopy, endosclerotherapy, poloypectomy etc.

Tel. (37410) 262130; 236 883, ext` 1217, 1216

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Arevik Nersesyan – nurse ; Tel. (37410) 262130; 236 883, ext` 2152, 2115, 1216

 

In pediatric gastroenterology activities are involved also:

Ruzanna Davtyan Rusan Davtyan, MD, pediatrician of the Department of General pediatrics of “Arabkir MC” – ICAH. Passed trainings in Saint-Petersburg (2014)

Scientific interests: FMF, IBD. Tel. (37410) 262130; 236 883, ext` 1181, 1216

 

Poghos Geyikyan Poghos Geyikyan – MD, pediatric surgeon, head of the Uro-Surgical Department of “Arabkir MC” – ICAH (hepatobiliary surgery/ planned surgery, kidney transplantation,  neonatal/ pediatric emergency). Passed trainings in Nicosia Makarios III Hospital (1994-1995); “Contemporary Issues of Pediatric Surgery “ – National Institute of  Health, Yerevan, 2007; “Full Course of Laparoscopic / Endoscopic Surgery” – National Institute of  Health, Yerevan, 2007; Deparment of Hepatobiliary, transplantation and Endocrine Surgery of University Hospital of Antwerp,2010; Practical Cours on abdominal ultrasound examinations; Doppler investigations of abdominal vessels and ultrasound assisted abdominal biopsy procedures – Department of Gastroenterology and Hepatology of University Hospital of Antwerp, 2010. Scientific interests: Surgical complications of FMF. Hepatobiliary, GE surgery, Neonatal surgery. Tel. (+37410) 236 883, ext` 2256, 1216

Needs

Support in:

  • Technical improvement of the endoscopic equipment and gastroenterology service (Hp C13 breath test, Sphincteromanometry, H2 breath test, PH- metry).
  • Implementation of some new laboratory investigations: ex. Anti- EMA test, etc.
  • Organization of modern Gastrointestinal/Liver pathology Service.

Plans for future

  • Continuing clinical and educational activities
  • Research projects:
  • pylory antibiotic resistance and sensitivity in Armenia (scientific thesis of Dr. T.Shahinyan)
  • Inflammatory bowel disease and Familial Mediaterranean Fever
  • Epidemiology and clinical peculiarities of the Celiac disease in Armenia
  • Surgical approaches to management of the Portal hypertension and Biliary atresia

Contacts: 262130; 236 883 (1213, 2115,1216)

Address: 30, Mamikonyantz str., 0004, Yerevan, Armenia

E-mails: gayaneamaryan@yahoo.com; shahinyantatevik@yahoo.com;