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Impaired gastric emptying in children with repaired esophageal atresia: a controlled study
M Montgomery1, R Escobar-Billing, P M Hellström
1Department of Pediatric Surgery, St Göran's/Karolinska Hospital, Karolinska Institute, Stockholm, Sweden.
Insights
Gastric emptying scintigraphy in children with repaired esophageal atresia shows delayed emptying compared to healthy peers. This safe and reliable method can identify potential issues associated with reflux symptoms.
Area of Science:
- Pediatric Gastroenterology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Scintigraphy is the gold standard for gastric emptying studies.
- Lack of standardized methods complicates pediatric gastric emptying assessments.
- Esophageal atresia repair can impact gastrointestinal function.
Purpose of the Study:
- To assess gastric emptying in pediatric patients with repaired esophageal atresia using scintigraphy.
- To compare gastric emptying parameters between patients and healthy children.
- To establish reference values for gastric emptying in healthy children.
Main Methods:
- Solid meal scintigraphy using Tc-99m labeled pancakes.
- Study included 10 patients (5-10 years) with repaired esophageal atresia and 11 healthy controls (5-11 years).
- Analysis of fractional meal retention, half-emptying time, lag phase, and emptying rate.
Main Results:
- Patients with repaired esophageal atresia exhibited longer half-emptying times and lag phases.
- Slower emptying rates and higher retention values at 60 and 90 minutes were observed in the patient group.
- Healthy children's gastric emptying values aligned with those reported for adults.
Conclusions:
- Scintigraphy is a safe, reliable, and easy method for pediatric gastric emptying studies with low radiation dose.
- Delayed gastric emptying is identified in patients with repaired esophageal atresia.
- Delayed emptying may correlate with reflux symptoms and abdominal complaints.
Background:
Scintigraphy is considered the "gold standard" for investigating gastric emptying. The lack of standards regarding registration technique and meal composition has been a problem especially in pediatric patients.
Methods:
In this study, gastric emptying of a solid meal was assessed by scintigraphy in 10 patients with repaired esophageal atresia (5 to 10 years old), and the results were compared with those in 11 healthy control children (5 to 11 years old). The meal consisted of pancakes with a fixed energy composition labeled with Tc-99m. Fractional meal retention values were plotted as a function of time.
Results:
Half-emptying time and lag phase values were longer in the patient group, whereas the emptying rate was slower and the retention values at 60 and 90 minutes were higher than in the control group. Extremely long lag phase and slow emptying rates were seen in two patients with reflux symptoms and abdominal complaints. Gastric emptying in healthy children has not previously been studied by scintigraphy. The results of this study show that values for gastric emptying of solids in healthy children correspond well to those reported in healthy adults.
Conclusion:
Scintigraphy is an easy and reliable method for gastric emptying studies in children. The radioactive dose can be kept very low, which makes it a safe method even for pediatric patients. Delayed gastric emptying can occur in patients who have repaired esophageal atresia, and may be associated with reflux symptoms and abdominal complaints.