Related Experiment Video
Updated: Aug 6, 2026
Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging
Published on: May 11, 2014
Barrett's esophagus in children. Diagnosis and management
H B Othersen1, R J Ocampo, E F Parker
1Department of Surgery, Medical University of South Carolina, Charleston.
Insights
Barrett's esophagus in children can be caused by acid reflux and gastric tubes. Successful treatment requires either acid reflux control or surgical resection of the affected esophageal segment.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Surgery
- Oncology
Background:
- Barrett's esophagus (BE) is rarely reported in children, with unclear therapeutic guidelines.
- BE typically arises from acid-reflux injury to the esophageal mucosa, with risk factors including GER, mental retardation, and esophageal strictures.
- Barrett's syndrome significantly elevates the risk of esophageal adenocarcinoma.
Purpose of the Study:
- To determine the local prevalence of Barrett's esophagus (BE) in children.
- To evaluate optimal therapeutic strategies for pediatric BE.
- To diagnose BE in children with esophageal strictures or gastroesophageal reflux (GER) and monitor outcomes post-therapy.
Main Methods:
- Children with risk factors for BE underwent repeated esophagoscopy and multiple mucosal biopsies.
- Diagnostic and therapeutic interventions were performed before and after treatment.
- Eleven pediatric cases of BE were identified and analyzed based on initial diagnosis and treatment received.
Main Results:
- Eleven children were diagnosed with BE, with initial diagnoses including GER (5), esophageal atresia (4), nasogastric intubation (1), and lye ingestion (1).
- Treatments varied: gastric tube esophagoplasty (3), total resection with colic interposition (3), colic-patch esophagoplasty (2), and fundoplication alone (3).
- BE was linked to gastric tubes, with some patients responding to H2 blockers and diet.
Conclusions:
- Barrett's esophagus in children can be caused by gastric tubes and acid reflux.
- Effective treatment necessitates either complete acid reflux control or resection of the involved esophageal segment.
- Esophagoplasty alone manages strictures but requires concurrent fundoplication; BE persists with incomplete reflux control.
Objective:
To determine the local prevalence and optimal therapy for children with Barrett's esophagus (BE), the authors studied children with esophageal strictures or gastroesophageal reflux (GER), or both, to diagnose BE and to follow after therapy.
Summary Background Data:
Barrett's esophagus is seldom reported in children and therapeutic recommendations are unclear. Barrett's esophagus usually develops during the mucosal reparative process after acid-reflux injury to the esophageal mucosa. Risk factors for BE include conditions that are associated with GER such as mental retardation, esophageal stricture, esophageal atresia, and reversed gastric tube esophagoplasty. Barrett's syndrome increases the risk of esophageal adenocarcinoma by 30 to 40 times.
Methods:
All children with the risk factors had repeated esophagoscopy and multiple mucosal biopsies before and after therapy.
Results:
Eleven children have been documented with BE. The initial diagnoses were: GER, 5; esophageal atresia, 4; nasogastric intubation, 1; lye ingestion, 1. A gastric tube esophagoplasty had been performed in three patients with BE in the esophagus proximal to the anastomosis. Three children with mid-esophageal strictures and long segments of BE had total resection with colic interposition. An additional two patients with tight stricture were treated with colic-patch esophagoplasty without resection. The final three patients were treated with fundoplication alone.
Conclusions:
Barrett's esophagus can be caused by acid from gastric tubes but responds to H2 blockers and diet. Resection eliminates BE; esophagoplasty only controls the stricture and must be accompanied by fundoplication. Barrett's esophagus persists in patients with fundoplication alone if reflux control is incomplete. The authors conclude that acid reflux must be controlled to treat BE successfully or the involved segment must be resected. Esophagogastrostomy apparently predisposes to BE.
Related Concept Videos
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
01:21Barrett Esophagus-I: Introduction
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more similar...
01:21Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
01:30Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
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...
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...