Factors Affecting The Diagnosis Of Gastroesophageal Reflux In Pediatric Patients Undergoing Upper Gastrointestinal Fluoroscopy
Abstract
Objective: The aim of this study was to evaluate the results of upper gastrointestinal fluoroscopy in infants and children and to investigate factors affecting results and the diagnosis of gastroesophageal reflux (GER).
Material and Methods: Patients between the ages of 1 month and 18 years who underwent upper gastrointestinal fluoroscopy at the Radiology Department of Dr. Sami Ulus Research and Training Hospital between January 1, 2018 and December 31, 2018 were included in the study. The files of the patients were reviewed retrospectively.
Results: Of the 76 patients who underwent upper gastrointestinal fluoroscopy, 46.1% were male and median age was 10 months. Among these, 2.6% (n=2) were diagnosed with mild GER, 18.4% (n=14) with moderate GER, and 38.2% (n=29) with severe GER. The accompanying anatomic pathologies were: malrotation (5.3%), operated esophageal atresia and diaphragmatic hernia (2.6%), organoaxial volvulus and prepyloric web (1.3%). Reasons of requesting upper gastrointestinal fluoroscopy were persistent vomiting in 40.8% (n=31), intermittent vomiting in 10.5% (n=8), and coughing in 11.8% (n=9). The most common accompanying pathologies were prematurity and growth retardation in 6.6% (n=5). 74.4% of those younger than 1 year of age were diagnosed with GER, while this percentage was 39.4% in those aged 1 year or older. The incidence of GER in patients younger than 1 year of age was found to be significantly higher (p=0.002). GER was present in 74.2% (n=23) of patients who had persistent vomiting, while it was present in 48.9% (n=22) of patients who underwent upper gastrointestinal fluoroscopy for other reasons. This difference was also statistically significant (p=0.027).
Conclusion: In cases where gastroesophageal reflux disease is suspected, if the patient is younger than 1 year of age or has persistent vomiting, upper gastrointestinal fluoroscopy may be useful to confirm the diagnosis. However, anatomical disorder can be detected in very few of the recommended UGF. From this point of view, it would be more appropriate for clinicians to recommend UGF in more suitable cases considering radiation related risks and procedure difficulties.
Keywords
References
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Details
Primary Language
English
Subjects
Internal Diseases
Journal Section
Research Article
Publication Date
May 29, 2020
Submission Date
January 13, 2020
Acceptance Date
May 7, 2020
Published in Issue
Year 2020 Volume: 14 Number: 3