Sonographic Measurement of the Abdominal Esophagus Length in Infancy: A Diagnostic Tool for Gastroesophageal Reflux

Koumanidou, C.; Vakaki, Marina; Pitsoulakis, George; Anagnostara, A.; Mirilas, Petros

doi:10.2214/ajr.183.3.1830801

Cited by 35 publications

(34 citation statements)

References 19 publications

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“…Other studies confirmed their findings [12,32,33]. In our study, although the IAEL did not significantly correlate with the severity of reflux in BS, we found that the IAEL was shorter in normal comparing with mild and moderate BS.…”

Section: Discussionsupporting

confidence: 86%

“…hiatus hernia, malrotation) [8] along with the valuable experiences that practitioners have acquired through the years since the 1980s, ultrasonography (US) has been used as an alternative to BS in the diagnosis of GERD [9]. Esophageal US has been described as a noninvasive, readily available, repeatable, cheap, and fast technique that could be commonly used in the diagnosis and follow-up of young children with GERD [10][11][12][13][14][15]. Comparative studies of transabdominal US and BS demonstrated that US presents a higher sensitivity in the diagnosis of GERD [16,17].…”

Section: Introductionmentioning

confidence: 99%

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A comparison between gastroesophagheal ultrasonography vs. barium swallow in determining the pattern of gastroesophageal reflux in a pediatric population

et al. 2015

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Background: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal pathology in infants and young children. Ultrasonography (US) has been considered to be a reliable diagnostic tool for GERD but the severity of GERD and the clinical implications based on imaging findings has not been evaluated. Aims: To compare the diagnostic value of lower esophageal US with that of barium swallow in demonstrating the severity of GERD. Materials and methods: Fifty one pediatric patients, age between 1 month to 12 years, 34 male and 17 female with clinical suspicion of GERD were included. The patients were initially submitted to barium swallow (BS) and subsequently to transabdominal US. During BS, the number of gastroesophageal reflux episodes was documented in a 5-minute period. Transabdominal US documented the number and duration of reflux episodes during a 5-minute period, the angle of His, mucosal thickness, and intraabdominal esophageal length (IAEL). Results: Duration and number of reflux episodes in US were significantly higher in patients that had severe gastroesophageal refluxes at BS. At US the cutoff point of 9.5 seconds (sensitivity 80%, specificity 60%) for reflux duration and more than 2 episodes in 5 minute ultrasound study (sensitivity 75%, specificity 58%) were defined to correlate with severe gastroesophageal reflux at BS.The angle of His, the esophageal wall mucosal thickness, and the IAEL did not correlate with the severity of GERD detected in BS. Conclusion: US can predict the severity of GERD. Therefore, except in the case of specific patients in whom mechanical causes are suspected to be responsible for GERD, BS can be replaced by US.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

A comparison between gastroesophagheal ultrasonography vs. barium swallow in determining the pattern of gastroesophageal reflux in a pediatric population

et al. 2015

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“…(14) Bir başka çalışmada ise, sonografik olarak abdominal özefagus boyu ölçümünün, GÖR tanısı konulmasında %94 oranında sensitiviteye sahip olduğunu gösterilmişdir. (15). Yenidoğanlarda GÖR'nün ilk bir ay içinde oldukça sık rastlandığı, fakat bu ay içindeki reflü-lerin daha çok nonasidik reflüler olduğu, çünkü anne sütünün asidik mide sıvısını tamponladığı ve bu nedenle de GÖR tanısında pH impedans ölçümünün daha anlamlı olduğunu bildirilmektedir (16).…”

Section: Discussionunclassified

GASTROÖZEFAGEAL REFLÜ ŞÜPHELİ ÇOCUKLARDA pH METRE SONUÇLARININ DEĞERLENDİRİLMESİ [Results of the pH meter in children with gastroesophageal reflux]

Gül

Celayir²,

Şahin³

et al. 2014

ZKTB

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ÖZETGiriş ve Amaç: Gastroözefageal reflü şüpheli olgularda 24 saatlik pH metre analizi önemli bir tanı yöntemi olarak güncelliğini korumaktadır. Klinik olarak kuvvetle gastroözefageal reflü şüpheli olgularda, pH metre analizi sonuçlarının klinik bulgu ile korale olup olmadığını saptamak amacıyla bu çalışma planlandı. Gereç ve Yöntem:Ocak 2006-Ocak 2008 yılları arasın-da gastroözefageal reflü şüpheli olgularımızda 24 saatlik çift kanalı kateter ile pH metre analizi yapıldı ve olguların tüm kayıtları değerlendirildi. Bulgular:Kliniğimizde pH metre analizi yapılan yapılan 109 hastanın 70'i erkek, 39'u kız olup ortalama yaşla-rı 22 ay (14 gün ile120 ay arasında) idi. pH metre ile reflü saptanan 31 olgunun 13'ü kız,18'i erkek idi. Reflü saptanan 31 olgunun 13'ü sık akciğer infeksiyonu, 5'i aralıklı kusma, 9'u kusma yakınması olan opere distal fistüllü özefagus atrezisi, 3'ü nörolojik defisitli olgu, 1'i ise diafragma hernisi nedeniyle opere olmuş idi. Fistüllü özefagus atrezisi nedeniyle opere olmuş 14 hastada yapı-lan pH metre sonucunda 9'unda reflü saptandı (%64), sık akciğer enfeksiyonu tanısı alan 59 hastanın 13'ünde reflü saptandı (%22). Sol diyafragma hernisi nedeniyle opere olan 7 hastanın sadece 1'inde reflü saptandı (%14). pH metre ile reflü saptanan 31 olgunun 8'inde reflü şiddeti ve süresi ameliyat gerektiren sınırlardaydı, bunlardan 6 yaşındaki kusma yakınmalı bir olgunun ailesi ameliyatı kabul etmedi, 7 olguda antireflü cerrahi girişim yapıldı. Bu olguların 5'i daha önce fistüllü özefagus atrezisi nedeniyle operasyon geçirmişti, diğer ikisi ise kusma yakınmalı olgulardandı.Sonuç: Gastroözofageal reflü hastalığı olan çok az bir hasta grubunda ameliyat endikasyonu konulmasında pHmetrenin katkısı olmuştur. Dolayısıyla her ne kadar noninvaziv olsa da 24 saat boyunca özefageal kateterin takılmasının vereceği rahatsızlık göz önüne alınarak, özellikle sık ÜSYE geçiren çocuklarda pH metre yapıl-masında daha seçici olunmalıdır.Anahtar Kelimeler: Gastroözefageal reflü, pH metre, özefagus manometresi, reaktif hava yolları. Results of the pH meter in children with gastroesophageal reflux.ABSTRACT Introduction and Aim: 24 hours pH meter analysis in patient with suspected gastroesophageal reflux has a significant recognition as a method to date. It is planned to determine pH meters analysis of the results correlated with clinical findings in patients with susected gastroesophageal reflux. Material and Method:Between January 2006 and January 2008 in patients with suspected gastroesophageal reflux investigement of the pH meter was made whit in the 24 hours period with a double-channel catheter, and all pH meter records were analyzed and evaluated.Results: pH meter analysis was made of the 109 patents, 70 males and 39 females. The mean ages was 22 months, ranged between 14 days and 120 months. 14 patients with operated for esophageal atresia with fistula, 59 patients with frequent lung infections, 7 pateints who underwent surgery for left diaphragmatic hernia undervent pH meter investigements. 31 cases with gastroesophag...

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“…Some studies have shown that a short lower portion of the thoracic esophagus can be visualized by transabdominal sonography performed through the window of the liver. [13][14][15] Zhu et al 16 suggested that despite its limitations, transthoracic sonography is an alternative for visualizing the thoracic esophagus in adults. In this study, we could not clearly show the thoracic esophagus in all of the children.…”

Section: Discussionmentioning

confidence: 99%

Use of Sonography for Evaluation of the Cervical and Thoracic Esophagus in Children

Palabıyık

Bayramoğlu

Güner

et al. 2012

Journal of Ultrasound in Medicine

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Objectives The purpose of this study was to determine the normal sonographic appearance of the cervical and thoracic esophagus and to provide corresponding measurements in healthy children. Methods In this prospective study, 93 children (51 girls and 42 boys) 1 to 15 years of age were examined sonographically. With the patient in a supine position for evaluation of the cervical esophagus, the ultrasound transducer was placed on both sides of the trachea. To evaluate the thoracic esophagus, the hands were raised over the head, and the ultrasound transducer was placed along the left side of the sternum. The length of the cervical esophagus was measured longitudinally, and the anteroposterior and transverse diameters of the cervical and thoracic esophagus were measured transversely, as was the thickness of the cervical esophageal wall. Results The cervical esophagus was identified in all of the children, whereas the thoracic esophagus was shown in 41 (44%) of the 93 participants. The length of the cervical esophagus and anteroposterior and transverse diameters of the cervical and thoracic esophagus increased with age. The mean thickness of the cervical esophagus was 2.8 mm at all ages. The cervical esophageal wall appeared as 5 layers on the sonograms, and the lumen was distinct. Conclusions Evaluation of the cervical esophagus was readily achievable with sonography in children, whereas visualization of the thoracic esophagus was difficult because of the deep location, small size, and influence of bones and gas in the lungs. Conventional sonography can be easily used in the evaluation of cervical esophageal diseases in children.

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Sonographic Measurement of the Abdominal Esophagus Length in Infancy: A Diagnostic Tool for Gastroesophageal Reflux

Abstract: Sonographic measurement of the abdominal esophagus length is highly diagnostic for GER in neonates and infants. In neonates, it can also indicate GER severity. Hiatal hernia is associated with a significantly shorter abdominal esophagus.

Cited by 35 publications

References 19 publications

A comparison between gastroesophagheal ultrasonography vs. barium swallow in determining the pattern of gastroesophageal reflux in a pediatric population

A comparison between gastroesophagheal ultrasonography vs. barium swallow in determining the pattern of gastroesophageal reflux in a pediatric population

GASTROÖZEFAGEAL REFLÜ ŞÜPHELİ ÇOCUKLARDA pH METRE SONUÇLARININ DEĞERLENDİRİLMESİ [Results of the pH meter in children with gastroesophageal reflux]

Use of Sonography for Evaluation of the Cervical and Thoracic Esophagus in Children

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