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Antroduodenal manometry findings in children with suspected pediatric intestinal pseudo-obstruction
Gullik Gulliksson1, Niklas Nyström1, Johan Danielson1
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Insights
Pediatric intestinal pseudo-obstruction (PIPO) diagnosis in children is linked to more abnormal antroduodenal manometry (ADM) findings. These results highlight the need for standardized ADM evaluation criteria in pediatric motility disorders.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
- Diagnostic Criteria Development
Background:
- Established 2018 diagnostic criteria for pediatric intestinal pseudo-obstruction (PIPO).
- Antroduodenal manometry (ADM) is key for diagnosing neuromuscular gastrointestinal dysfunction.
- Limited data exists on ADM in children.
Purpose of the Study:
- Retrospectively apply 2018 PIPO criteria to children with suspected motility disorders.
- Reevaluate antroduodenal manometry patterns in these children.
- Compare ADM findings between children meeting PIPO criteria, those not meeting criteria, and healthy adults.
Main Methods:
- Retrospective analysis of 34 children with suspected gastrointestinal motility disorders.
- Application of 2018 ESPGHAN/NASPGHAN PIPO criteria and 2018 ANMS-NASPGHAN guidelines.
- Comparison of 24-h 8-lead ADM findings across PIPO, non-PIPO, and healthy adult control groups.
Main Results:
- 12 out of 34 children met the 2018 PIPO criteria.
- Children with PIPO diagnosis showed a significantly higher degree of abnormal ADM patterns (2.33 vs. 1.23, p=0.02).
- No major quantitative ADM differences were observed, except for higher pressures in children.
Conclusions:
- Children fulfilling PIPO criteria exhibit significantly more abnormal ADM findings.
- This supports the utility of ADM in diagnosing PIPO.
- Standardized criteria for evaluating ADM in pediatric PIPO are necessary.
Background:
In 2018 diagnostic criteria for pediatric intestinal pseudo-obstruction (PIPO) were established. Neuromuscular dysfunction of the gastrointestinal tract is one of these, and often examined through antroduodenal manometry (ADM). There is little data on antroduodenal manometries in children. Our objectives were to retrospectively apply these criteria to children evaluated for suspected motility disorder, to reevaluate the ADM patterns and compare children who did and did not meet the PIPO criteria and also with healthy adults.
Methods:
Children with a suspected gastrointestinal motility disorder previously investigated with 24-h 8-lead ADM were reevaluated by applying the 2018 ESPGHAN/NASPGHAN PIPO diagnostic criteria and the 2018 ANMS-NASPGHAN guidelines. ADM findings were compared between children who retrospectively fulfilled a PIPO diagnosis, children who did not, and a control group of healthy adults.
Key Results:
Of 34 children (age 7.9 (±5.1) years, 18 males), 12 retrospectively fulfilled the 2018 PIPO diagnostic criteria. Twenty-five children (10 in the PIPO group) had abnormal diagnostic findings on ADM, whereas 9 (2 in the PIPO group) had no such findings. A PIPO diagnosis implied a significantly higher degree of abnormal ADM patterns (2.33 vs. 1.23, p = 0.02). There were no major differences in quantitative ADM measurements between the groups except higher pressures in children.
Conclusions And Inferences:
Children who retrospectively fulfilled a PIPO diagnosis had a significantly higher abundance of abnormal ADM findings compared with symptomatic children without PIPO and healthy adults. Our data indicate a need for set criteria for evaluation of ADM in children with suspected PIPO.
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