Esophageal Diameters in Children Correlated to Body Weight

Abstract

Introduction The development of stenoses after correction of an esophageal atresia or acid and lye burn of the esophagus are well-known problems in pediatric surgery. Currently, stenoses are treated in the majority of cases by repeated balloon dilatations. The diameter of the balloons used is not standardized; standard curves do not exist. The aim of this study was to evaluate the diameter of the esophagus correlated to the body weight of the children as measured in upper gastrointestinal (GI) studies to answer the important question to what extent a stenosis should be dilated. Materials and Methods Within the time period from 2011 through 2016, 60 patients with upper GI studies were selected. Evaluations were blinded to two different examiners. The diameters were measured under maximum contrast filling between the second and third rib (cranial point of measurement) and between the seventh and eighth rib (caudal point of measurement). For both, the anteroposterior and lateral aspect was examined. The diameter was calculated as the arithmetic average of both measurements within one level. The diameters were correlated to the weight of the children. Results All children (n = 38) within the 3rd to 97th weight percentile were analyzed. Linear correlation and coefficients of 0.67 at the cranial point and 0.70 at the caudal point were found. Mean diameter at the cranial point of measurement was 6.75 mm at the lowest weight (2.6 kg) and 14 mm at 74 kg. Mean weight of these children (standard deviation [SD]) was 25.3 (18.8) kg and median age was 7 years. Within weight groups (0–10 kg; 10–20 kg; 20–35 kg; 35–50 kg; >50 kg), we calculated SD and two side tested critical 95% confidence interval for all measurements (n = 74). Conclusion Although the variation in measurements is considerable, this evaluation gives a reliable hint to which extent esophageal stenoses should be dilated in relation to the body weight. To the best of our knowledge, this is the first investigation to evaluate the diameter of the esophagus in children in relation to the body weight.

Never fish your brother: a case of plastic fish hook in the oesophagus

“…However, some cases of suspected migrating FB usually require computed tomography. In our case, the suspicious radiopaque FB seen was relatively small (about 0.5 × 0.5 cm) compared to the diameter of the oesophageal lumen (9.5 ± 2.4 mm for children weighing 20-35 kg) (8) and should have been able to pass down the GIT easily. However, the image was not representative of the actual size of the impacted FB, which was larger and made up mainly of radiolucent component (plastic).…”

Stent para el manejo de las Estenosis Esofágicas por cáusticos en pediatría

“…Tienen un avanzado diseño técnico y existe una gran experiencia en adultos, lo que lo sitúa como la elección más indicada en la actualidad. En el paciente se dispuso de dos stent de vías biliares para poder cubrir la longitud de la lesión, la cual se consideraba complicada al ser de más de 2 cm; el diámetro fue elegido basado en el peso corporal 18 . Hay reportes que han utilizado múltiples stent al tiempo o se han realizado inserciones repetidas 19 .…”

Esophageal length in children: Reference data and a novel predictive equation

“…Esophageal diameter has also been investigated in children. In a small study of 38 children, Bott et al (2019) measured esophageal diameters from radiographic contrast studies and correlated these with body weight. The study group consisted of children aged 7 days to 16 years, weighing 2.6–73.8 kg; some had gastroesophageal reflux disease which could skew the results.…”