Suarez-Nadal JE, Gonzalez-Romero G, Romero-Montes, Camacho-Coronado R, Valencia-Moncada JI, Samano-Pozos J

Language: Spanish
References: 9
Page: 80-83
PDF size: 277.20 Kb.

ABSTRACT

Introduction: Gastroesophageal reflux surgery is the second or third in pediatric surgical pathology, with good results and excellent prognosis, several studies have been used for diagnosis, and thus determine the need for a surgical procedure for gastroesophageal reflux develop this work to determine which is the study more sensitive, specific, and greater accessibility.
Material and Methods: We conducted a review of medical records of March 2000 to March 2005 patients evaluated for gastroesophageal reflux, aged 12 months to 14 years of age, who underwent imaging studies and scintigraphy, by endoscopy in all patients to present disparity in the studies or in those patients who had a atopic important component.
Results: We analyzed 239 cases with a total of 67 patients who met the characteristics of the study where we found an incidence of male compared to female of 1.1 to 1, and the patients pre-school three years which prevailed in 29.7% with the main symptoms of reflux patients with respiratory disease.
In the upper GI series diagnostic studies, yielded negative results in 22.3% of patients, the scan was negative gastroesophageal reflux in 35.8% of patients and endoscopy found no macroscopic esophagitis in 41.8% of patients, incompetence of the hiatus in the 29.8% of cases.
Discussion: In our hospital has a slight male predominance ratio of 1.1 to 1, and greater age at presentation is three years, found in the upper GI series studies a sensitivity of 78.7% and specificity of 93.4% as that series of 52 patients with positive in only four of them were negative histopathology, the gamagrama provided a sensitivity of 64.2% and specificity of 92.8% as of 43 positive studies, only in three cases the histopathologic negative endoscopic sensitivity to macroscopic esophagitis is only 58.2% of cases but the sensitivity reaches 100%, since all the positive studies were corroborated histologically.
In our study more accessible, sensitive and specific imaging was with upper GI series, while the most conclusive studies was endoscopy with biopsy.

REFERENCES

1. Guarino N, Ceriati E, Zaccara A: Is endoscopio follow up hended in pediatric patients who undergo surgery for GERD?. Gastrointest endos 2002; 55

2. Hassall E. Decisions in diagnosing and managing chronic gastroesophageal reflux disease in children. J of Pediatr 2005; 146

3. Aksglaede K, Funch-Jensen P, Thommensen P. Radiological demonstration of gastroesophageal reflux. Diagnostic value of barium and bread studies compared with 24-hour pH monitoring. Acta Radiol 1999; 40: 652-5

4. Fawcett HD, Hayden CK, Adams JC, Swischuk LE. How useful is gastroesophageal reflux scintigraphy in suspected childhood aspiration?. Pediatr Radiol 1988; 18: 311-3

5. Cappell MS, Friedel D. The role of esophagogastroduodenoscopy in the diagnosis and management of upper gastrointestinal disorders. Med Clin of North Am 2002; 86

6. Brindley N, Sloan JM, Mc Callion WA. Esophagitis: optimizing diagnostic yield by biopsy orientation. J Pediatr Gastroenterol Nutr 2004; 39: 262-4

7. Benjamin D. Gastroesophageal reflux disease: Could intervention in childhood reduce the risk of later complications?. Am J Med Suppl 2004; 117

8. Jain A, Patwori AK, Bajaj P, Kashyap R, Anaud VK. Association of gastroesophageal reflux disease in young children with persistent respiratory symptoms. J Trop Pediatr 2002, 48: 39-42

9. Benjamin D. Asthma and gastroesophageal reflux disease in children: Exploring the relation ship. J of Pediatr 2005; 146