Related Experiment Video
Updated: Jun 7, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Establishing normal values for pediatric esophageal diameter on fluoroscopy
Chelsea S Life1, Brandon D Buck2, Colin Gardner3
1Department of Radiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA. chelsea.life@cuanschutz.edu.
Insights
Standardized esophageal diameter values were established for children aged 1-17 years using fluoroscopy. These new pediatric reference ranges aid in diagnosing esophageal narrowing and related conditions.
Area of Science:
- Pediatric Radiology
- Gastroenterology
- Medical Imaging
Background:
- Standardized esophageal diameter values for fluoroscopy are currently lacking.
- This deficiency hinders the diagnosis of subtle esophageal narrowing in pediatric patients.
Purpose of the Study:
- To establish age-based normal values for esophageal diameter in children aged 1 to 17 years.
- To provide quantitative metrics for interpreting fluoroscopic examinations of the pediatric esophagus.
Main Methods:
- Retrospective analysis of 160 pediatric patients with normal upper gastrointestinal fluoroscopy and biopsy.
- Esophageal diameters measured at three locations and two projections by three readers.
- Statistical analysis including intra-class correlation coefficients and Student's t-tests.
Main Results:
- Excellent inter-reader measurement agreement (ICCs > 0.75) was achieved.
- A linear increase in esophageal diameter with age was observed.
- Mean esophageal diameters ranged from 11-21 mm (anteroposterior) and 8-17 mm (lateral) across all ages.
Conclusions:
- Established normal esophageal diameter ranges provide quantitative metrics for pediatric fluoroscopy interpretation.
- These new reference values may facilitate earlier diagnosis of esophageal pathology in children.
Background:
Standardized values for esophageal diameter on fluoroscopy have not been established. These values may help in the diagnosis of long-segment and diffuse esophageal narrowing, which can sometimes be subtle and difficult to diagnose.
Objective:
Our objective was to establish normal values for esophageal diameter based on age for patients between 1 and 17 years old.
Materials And Methods:
Our retrospective study included 160 patients separated into eight groups by age with documented normal upper gastrointestinal fluoroscopic examination and normal esophageal biopsy. Three readers measured esophageal diameters in the three locations and two projections. Intra-class correlation coefficients were calculated in order to gauge reader measurement agreement. Student's t-tests were used to evaluate for statistically significant differences between male and female patients. Finally, overall means and 95% confidence intervals were calculated at each esophageal level by age group.
Results:
Our readers demonstrated excellent measurement agreement (ICCs > 0.75). Three individual esophageal measurements varied between the biological sexes, but there was no reliable statistically significant difference. There was a linear upward trend in esophageal diameter with age. For each age group, the means, standard deviations, and 95% confidence intervals were calculated for esophageal diameter in each location and projection. Across all included ages, the mean esophageal diameter ranged from 11-21 mm on the anteroposterior projection and 8-17 mm on the lateral.
Conclusion:
The provided ranges of normal esophageal diameters at each age and location in the pediatric population are quantitative metrics which can be used in the interpretation of fluoroscopic examinations. New reference values may lead to earlier diagnosis of esophageal pathology in the pediatric population.
Related Concept Videos
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...