Radionuclide scintigraphy in the evaluation of gastro-oesophageal reflux in post-operative oesophageal atresia and tracheo-oesophageal fistula patients

Thomas, E J; Kumar, Rakesh; Dasan, J Bharathi; Chandrashekar, N.; Agarwala, Sandeep; Tripathi, Madhvi; Bal, Chandrashekhar

doi:10.1097/00006231-200303000-00012

Cited by 16 publications

(4 citation statements)

References 15 publications

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“…As both wheezing as well as GER is very common in infancy the presence of GER in a wheezy child may either be causally related or else may be a mere coincidence, or may be secondary to wheezing and its medications 7. The patients who have “silent” GER can be symptomatic due to wheezing 8. Anti‐reflux treatment improves symptoms in many of these wheezing children.…”

Section: Introductionmentioning

confidence: 99%

Gastro‐esophageal reflux in early childhood wheezers

Patra

Singh

Chandra

et al. 2010

Pediatric Pulmonology

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Wheezing is common among infants and young children due to peculiar anatomical and physiological properties of their lungs. Gastro-oesophageal reflux (GER) has been incriminated as one of the cause of non-asthmatic wheezing in this age group. The present study evaluates the magnitude of GER and its causal relationship with wheezing in early childhood. All recurrent and persistent wheezers (under two years) were investigated for GER and treated medically where tests were positive. The subjects were further profiled to identify any predictors for GER. Sixty-seven children of less than 2 years age with recurrent or persistent wheezing were evaluated for GER. Mean age of the study subjects at enrolment was 10.8 months and at onset of wheezing was 7.1 (± 3.8 S.D) months. Asthma and wheeze associated lower respiratory tract infection (WALRI) was diagnosed in about 1/3 each of the patients studied. GER studies were positive in over one-third (25/67) of cases. Forty-two percent of children who wheezed by 1 year of age had a positive GER study. Interestingly, nearly half (12/25) of the patients with an abnormal study did not have any clinical suggestion of regurgitation ("silent" GERs). The severity of wheezing was higher among those who had GER versus those who did not (p ≤ 0.048; OR: 3.2). However, only 32% patients showed significant response to anti reflux treatment alone while others had partial response. GER, therefore, is an important cause for recurrent wheezing among children less than 2 years of age, either singularly or as a co-morbidity. The study findings justify investigations for GER among early wheezers; particularly for those who have onset of symptoms by 12 months of age or those who have severe disease.

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Section: Introductionmentioning

confidence: 99%

Gastro‐esophageal reflux in early childhood wheezers

Patra

Singh

Chandra

et al. 2010

Pediatric Pulmonology

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“…Scintigraphy is at present an accepted method to investigate esophagogastric motility in children. [18][19][20][21][22] The aims of this study were to assess whether surgical procedures undertaken to achieve direct anastomosis in long-gap EA affect the midterm clinical outcome and esphagogastric motor function and the relationship between these two outcome markers. Our hypothesis was that, within the second year following esophageal anastomosis, both groups would achieve similar clinical and scintigraphic findings with a definite relationship.…”

Section: Introductionmentioning

confidence: 99%

“…However, the bulk of studies performed to characterize functional disturbances have been almost exclusively focused on the most common type of defect (EA and distal TEF without long‐gap), 12–18 with information lacking in the long‐gap subset population. Scintigraphy is at present an accepted method to investigate esophagogastric motility in children 18–22 . The aims of this study were to assess whether surgical procedures undertaken to achieve direct anastomosis in long‐gap EA affect the midterm clinical outcome and esphagogastric motor function and the relationship between these two outcome markers.…”

Section: Introductionmentioning

confidence: 99%

Midterm follow-up of esophageal anastomosis for esophageal atresia repair: long-gap versus non-long-gap

Lopes¹,

Botelho

2007

Diseases of the Esophagus

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Current approaches to the repair of long-gap esophageal atresia (EA) favor esophageal anastomosis. This investigation provides a midterm follow-up of long-gap EA with a primary repair to determine whether this procedure affects symptom severity and whether symptom severity may predict worsening of dysmotility. Fifteen children at least 1-year post primary repair were divided into group 1 (long-gap) and group 2 (non-long-gap). The severity of their symptoms was graded using a questionnaire focused on their eating habits and gastroesophageal motor dysfunction symptoms. Esophageal transit time and gastric emptying were assessed by scintigraphy and used to grade esophagogastric dysmotility. At midterm follow-up the majority of patients in both groups were asymptomatic (66% in group 1 vs 77.7% in group 2; P > 0.05). Esophagogastric dysmotility grades for group 1 were more severe than for group 2 (median 2.5, range from 1 to 4 vs median 1, range from 1 to 2, respectively; P > 0.05). We found no relationship between the severity of the symptoms and the presence or severity of esophagogastric dysmotility. At midterm follow-up in patients with long-gap atresia that underwent primary repair, this study showed scintigraphic evidence of silent and serious esophagogastric dysmotility in symptom-free or minimally symptomatic children. It may therefore be unreliable to use symptoms in assessing the severity of esophagogastric dysmotility, since both groups showed similar clinical findings but different scintigraphic findings.

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“…Our research is also based on the above report. However, so far, most salivagram examinations have been performed for children and rarely for adults (13)(14)(15)(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

Detection of Oesophageal Fistula by Radionuclide Salivagram SPECT/CT

Wang

Liu

et al. 2021

Front. Oncol.

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PurposeVideofluoroscopic swallowing study (VFSS) is currently the most widely used clinical examination method for diagnosis of oesophageal fistula, but it has many limitations. Therefore, we evaluated radionuclide salivagram single-photon emission computed tomography (SPECT/CT) as a new method of oesophageal fistula diagnosis.MethodsWe retrospectively evaluated the data of 11 patients (10 men and 1 woman, aged 41 to 70 years, with an average age of 58.6 years) who had clinically suspected oesophageal fistula from January 2019 to October 2020. They underwent radionuclide salivagram SPECT/CT and VFSS examinations, and we analysed and compared the results of the two examinations.ResultsA total of 11 patients were included in this study. Ten underwent both salivagram and VFSS examinations. One patient was unable to swallow the contrast agent; therefore, only salivagram was performed, and we excluded this patient from the VFSS analysis. A total of 11 patients underwent salivagram examinations, of which 6 were positive and 5 were negative. A total of 10 patients were tested by VFSS, of which 6 results were positive and 4 were negative.ConclusionRadionuclide salivagram SPECT/CT and VFSS are complementary, which can greatly improve the clinical diagnosis and prognosis of oesophageal fistula. When the patient cannot perform the VFSS, or the clinical symptoms are inconsistent with the VFSS imaging findings, the salivagram is an ideal test method.

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Radionuclide scintigraphy in the evaluation of gastro-oesophageal reflux in post-operative oesophageal atresia and tracheo-oesophageal fistula patients

Cited by 16 publications

References 15 publications

Gastro‐esophageal reflux in early childhood wheezers

Gastro‐esophageal reflux in early childhood wheezers

Midterm follow-up of esophageal anastomosis for esophageal atresia repair: long-gap versus non-long-gap

Detection of Oesophageal Fistula by Radionuclide Salivagram SPECT/CT

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