Gastric Emptying Studies in Pediatrics: A Cincinnati Children's Hospital Experience

Joseph Joby MacLean1, Khalil El-Chammas2

  • 1Nuclear Medicine Section, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and joseph.maclean@cchmc.org khalil.el-chammas@cchmc.org.

Insights

Standardizing gastric emptying studies with a consistent meal and 4-hour imaging protocol improves patient care. This nuclear medicine technique aids in diagnosing gastric emptying abnormalities.

Area of Science:

  • Nuclear Medicine
  • Gastroenterology
  • Pediatric Imaging

Background:

  • Gastric emptying studies are crucial for diagnosing gastrointestinal motility disorders.
  • Varied methodologies exist nationwide, leading to inconsistencies in clinical practice.
  • Standardization is needed to improve diagnostic accuracy and patient care.

Purpose of the Study:

  • To implement and evaluate a standardized protocol for pediatric gastric emptying studies.
  • To improve consistency in clinical practice for gastric emptying assessments.
  • To optimize workflow and patient care in a high-volume nuclear medicine setting.

Main Methods:

  • Adoption of adult standards for pediatric gastric emptying studies, including a standardized meal and 4-hour imaging.
  • Modifications to scheduling templates, questionnaires, and electronic order sets.
  • Empowerment of nuclear medicine technologists to make protocol deviations based on patient tolerance, with documentation.

Main Results:

  • Successful implementation of a standardized protocol for pediatric gastric emptying studies.
  • Demonstrated ability to accommodate high patient volumes through workflow optimization.
  • Established a consistent approach to evaluating gastric emptying with solid, liquid, or mixed meals.

Conclusions:

  • Protocol standardization and workflow optimization are essential for consistent patient care in gastric emptying studies.
  • Standardized protocols, with documented deviations, enhance diagnostic value for gastroenterologists.
  • The implemented protocol facilitates accurate diagnosis and treatment of gastric emptying abnormalities.

Related Concept Videos

Gastric Emptying01:16

Gastric Emptying

Gastric emptying occurs when the stomach gradually releases chyme into the duodenum. When the stomach is distended, it triggers the release of gastrin, a hormone that promotes gastric acid secretion to aid in digestion. Additionally, stomach distension contributes to peristaltic waves that propel gastric contents toward the pyloric region. The gastroenteric reflex, on the other hand, primarily stimulates peristalsis in the intestines, facilitating the movement of contents further along the...
Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy01:26

Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy

This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and solid...
Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
Upper GI Series: Barium Swallow01:24

Upper GI Series: Barium Swallow

The Barium Swallow Study, or a Barium Esophagogram, is a diagnostic imaging method used to visualize the upper gastrointestinal (GI) tract, including the esophagus, stomach, and small intestine. It employs barium sulfate, a radiopaque contrast material, to provide clear images of the upper digestive system, helping to identify abnormalities, diseases, or structural issues.
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pyloric Obstruction01:11

Pyloric Obstruction

Pyloric obstruction, also referred to as gastric outlet obstruction, is a condition characterized by narrowing or blockage at the pylorus—the muscular valve regulating the flow of stomach contents into the duodenum. When this passage becomes impaired, the stomach cannot effectively empty its contents into the small intestine. This disruption leads to a range of gastrointestinal symptoms, including early satiety, bloating, epigastric pain, postprandial nausea, persistent vomiting, and...