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Factors associated with hiatal hernia in neurologically impaired children
In Hyuk Yoo1, Jung Yeon Joo1, Hye Ran Yang1,2
1Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
Insights
Hiatal hernias in neurologically impaired children can lead to severe complications. Early predictors like prolonged neurological disease and aspiration pneumonia history aid in timely diagnosis and treatment.
Area of Science:
- Pediatric Gastroenterology
- Neurology
Background:
- Hiatal hernia impairs the anti-reflux mechanism, increasing risk of gastroesophageal reflux-induced injury.
- Diagnosis is critical in neurologically impaired children due to severe complications like aspiration pneumonia and malnutrition.
- This study evaluated patient characteristics and early predictors of hiatal hernia in this population.
Purpose of the Study:
- To identify early predictors of hiatal hernia in neurologically impaired children.
- To facilitate timely diagnosis and management to prevent severe complications.
Main Methods:
- Retrospective analysis of 97 neurologically impaired children.
- Inclusion of esophagogastroduodenoscopy and upper gastrointestinal series findings.
- Statistical analysis of demographic, clinical, endoscopic, and radiological data.
Main Results:
- Hiatal hernia was diagnosed in 22.7% of patients.
- Early predictors identified: neurological disease >6 months, wasting, enteral tube feeding, and history of aspiration pneumonia.
- Significant odds ratios were calculated for each predictor.
Conclusions:
- Early identification of hiatal hernia predictors is crucial for neurologically impaired children.
- Prompt diagnosis enables optimal medical or surgical treatment.
- Preventing complications like aspiration pneumonia and malnutrition is paramount.
Background:
Hiatal hernia is clinically important because it impairs the protective mechanism that prevents gastroesophageal reflux-induced injury. Diagnosing hiatal hernia is more important in neurologically impaired children because hiatal hernia-induced gastroesophageal reflux often causes severe complications such as aspiration pneumonia or malnutrition. We aimed to evaluate the patient characteristics and early predictors of hiatal hernia in neurologically impaired children.
Methods:
We retrospectively investigated 97 neurologically impaired children who underwent esophagogastroduodenoscopy and upper gastrointestinal series between March 2004 and June 2019. Demographic and clinical characteristics, as well as endoscopic and radiological findings, were statistically analyzed.
Results:
Of the 97 children recruited, 22 (22.7%) had hiatal hernia. When comparing the non-hiatal hernia group with the hiatal hernia group, neurological disease longer than 6 months (odds ratio 10.9, 95% confidence interval 1.2-96.5), wasting (odds ratio 4.6, 95% confidence interval 1.3-16.3), enteral tube feeding (odds ratio 9.2, 95% confidence interval 1.6-53.0), and history of aspiration pneumonia (odds ratio 6.5, 95% confidence interval 1.2-34.5) were identified as early predictors of hiatal hernia.
Conclusions:
Timely identification of predictors of developing hiatal hernia in neurologically impaired children is important for early diagnostic confirmation to initiate optimal medical or surgical treatment of hiatal hernia to avoid serious complications such as aspiration pneumonia and malnutrition.
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