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Barrett's esophagus in an infant: a long standing history with final postsurgical regression
S Conti Nibali1, G Barresi, G Tuccari
1Institute of Clinical Pediatrics, University of Messina, Italy.
Insights
Barrett's esophagus in infants is rare. Antireflux surgery successfully regressed Barrett's esophagus in a 4-month-old infant, unlike medical therapy, suggesting surgical intervention may be effective for pediatric gastroesophageal reflux complications.
Area of Science:
- Pediatric Gastroenterology
- Gastroenterology
- Esophageal Diseases
Background:
- Barrett's esophagus is uncommon in children, with limited data on regression after treatment.
- Existing research on antireflux surgery for pediatric Barrett's esophagus shows disappointing results.
Observation:
- A 4-month-old infant with severe reflux esophagitis developed junctional-type Barrett's epithelium.
- Histochemical analysis was performed to examine the mucin pattern.
Findings:
- Antireflux surgery led to the regression of Barrett's esophagus within 4 months.
- Medical therapy alone was unsuccessful in treating the condition.
Implications:
- Esophageal biopsy is recommended for infants presenting with severe esophagitis.
- Further research is needed to establish the role of antireflux surgery in managing pediatric Barrett's esophagus associated with gastroesophageal reflux (GER).
Abstract:
Data on the frequency of regression of Barrett's esophagus after medical therapy or antireflux surgery in adult patients are conflicting; these data, with regard to pediatric age, where Barrett's esophagus is considered rare, are scarce and disappointing after antireflux surgery. We report a 4-month-old infant affected by severe reflux esophagitis who developed a junctional-type Barrett's epithelium. Histochemical procedures to detect mucin pattern were also carried out. The regression of Barrett's esophagus was observed 4 months after antireflux surgery whereas medical therapy had been unsuccessful. We suggest that esophageal biopsy should also be performed in the presence of severe esophagitis. Longer follow-up observations of other patients may clarify the role of antireflux surgery when Barrett's esophagus complicates gastroesophageal reflux (GER).