Related Experiment Videos
The child with peptic esophagitis: a correlation of radiologic signs with esophageal pathology
Insights
Radiologic findings in children with gastroesophageal reflux are often normal, especially in mild cases. However, barium esophagography can help identify severe esophagitis, aiding diagnosis in advanced pediatric reflux disease.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
Background:
- Gastroesophageal reflux (GER) is common in children.
- Accurate diagnosis of esophagitis severity is crucial for effective management.
Purpose of the Study:
- To correlate radiologic findings with esophageal biopsy results in children with GER.
- To assess the diagnostic value of barium esophagography in pediatric esophagitis.
Main Methods:
- Prospective study of 35 children with GER.
- Correlation of radiologic findings (barium esophagography) with esophageal biopsy histology.
- Assessment of mucosal inflammation and esophageal function abnormalities.
Main Results:
- No consistent radiologic abnormalities in 24/35 children with minimal to moderate esophagitis or normal histology.
- Positive radiologic findings (mucosal inflammation, functional abnormalities) in 6/7 patients with severe or ulcerative esophagitis.
- Barium esophagography was valuable in detecting advanced disease; absence of findings largely excluded severe esophagitis.
Conclusions:
- Radiologic findings are insensitive for mild to moderate pediatric esophagitis.
- Barium esophagography is useful for diagnosing severe or ulcerative esophagitis in children.
- Age correlates significantly with the histologic severity of esophagitis.
Abstract:
Thirty-five children with gastroesophageal reflux were examined in a prospective study in which radiologic findings were correlated with the esophageal biopsy. No consistent radiologic abnormality was found in 24 children with minimal to moderate esophagitis and in three children with normal histology. Positive radiologic findings were found in five out of seven patients with severe, or severe ulcerative, esophagitis and in one child with moderate esophagitis. The positive radiologic findings consisted of signs of mucosal inflammation (mucosal edema, ulceration, esophageal narrowing) in five cases and abnormalities of esophageal function (aperistalsis, continuous reflux) in three. In children with peptic esophagitis, the barium examination of the esophagus appeared to be of diagnostic value only in the small number of patients with advanced disease; the absence of radiologic signs (with one exception) excluded severe inflammation. A statistically significant correlation was found between age and the histologic severity of esophagitis.