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Ultrasonography and gastric emptying: evaluation in infants with gastroesophageal reflux
Insights
Ultrasonography effectively assesses gastric emptying in infants. Gastroesophageal reflux patients exhibit varied emptying patterns, with 20% normal, 15% abnormal, and 65% intermediate emptying.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Infant Health
Background:
- Gastroesophageal reflux is common in infants.
- Accurate assessment of gastric emptying is crucial for diagnosis and management.
- Current methods for evaluating gastric emptying in infants have limitations.
Purpose of the Study:
- To evaluate the utility of ultrasonography for assessing gastric emptying in infants.
- To compare gastric emptying patterns in normal infants versus those with gastroesophageal reflux.
- To categorize gastric emptying abnormalities in infants with gastroesophageal reflux.
Main Methods:
- Utilized a simplified ultrasonography technique to measure gastric emptying.
- Investigated two groups: normal infants and infants diagnosed with gastroesophageal reflux via 24-h pH monitoring.
- Administered a standardized milk formula meal after a 4-h fast, measuring antral cross-sectional area over 2 hours.
Main Results:
- Gastric emptying was categorized into three types: Type I (normal), Type II (intermediate), and Type III (abnormal).
- In infants with gastroesophageal reflux, 20% showed Type I (normal) emptying, 15% showed Type III (abnormal) emptying.
- The remaining 65% of infants with gastroesophageal reflux presented with Type II (intermediate) emptying patterns.
Conclusions:
- Ultrasonography provides a reliable method for evaluating gastric emptying in infants.
- Infants with gastroesophageal reflux demonstrate diverse gastric emptying patterns, including normal, abnormal, and intermediate types.
- The findings align with existing literature, supporting ultrasonography's role in pediatric gastroenterology.
Abstract:
We have applied ultrasonography to the evaluation of gastric emptying in children. Two different populations have been investigated: normal children and children with gastroesophageal reflux. All the patients were less than 6 months of age. The diagnosis of gastroesophageal reflux was defined by 24-h pH measurement. The technique, used to measure gastric emptying, is the one described by Bolondi et al. In this research we used the simplified method. All children had been submitted to the examination after 4-h fasting. The standard meal was the usual milk formula, 300 ml/m2 body surface area (BSA). A cross-section area of the gastric antrum was determined before a meal and every 15 min for 2 h. The examination was concluded after two measurements were equal to the basal one. The normal gastric emptying curve was determined by a control group. Patients with gastroesophageal reflux showed three different kind of gastric emptying: (a) normal gastric emptying in 20% of cases, (b) abnormal gastric emptying in 15% of cases, and (c) intermediate cases in which the plateau curve is abnormal but the end time of gastric emptying is normal. We defined these three kinds of curves as type I or normal, type III or abnormal, and type II or intermediate. The estimate of frequency in patients with gastroesophageal reflux is similar to the reported data of the literature.