Hamid Dehdashti, Masoud Dehdashtian, Fakher Rahim,1 and Mehrdad Payvasteh2
Radiology and MRI Department, Golestan Hospital, Ahwaz Jondishapour University of Medical Sciences, Ahwaz, Iran
1Physiology Research Center, Ahwaz Jondishapour University of Medical Sciences, Ahwaz,Iran
2Paediatric Surgery Ward, Imam Khomeini Hospital, Ahwaz Jondishapour University of Medical Sciences, Ahwaz, Iran
Address for correspondence: Dr. Fakher Rahim, Physiology Research Center, Ahwaz Jondishapour University of Medical Sciences, Ahwaz, Iran. E-mail: email@example.com [pic]
Received July 15, 2009; Accepted March 26, 2010.
This is an open-access article distributed under theterms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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This study was conducted to provide sonographic measurements of the abdominal esophagus length in neonates and infants with andwithout gastroesophageal reflux disease (GERD) and to investigate its diagnostic value. GERD severity was also evaluated and correlated with esophageal length. It is a prospective case-control study.
Materials and Methods:
This prospective case-control study comprised 235 neonates and infants (120 without reflux and 115 with reflux). There were 40 children without reflux in each of three agecategories: less than 1 month, 1–6 months, and 6–12 months. Of the children with reflux, 40 were less than 1 month old; 37, 1–6 months; and 38, 6–12 months. The abdominal esophagus was measured from its entrance into the diaphragm to the base of gastric folds in fed infants. GERD was sonographically diagnosed and confirmed by a barium meal. The number of refluxes during a 10-min period were recorded.Results:
Neonates and infants with reflux had a significantly shorter abdominal esophagus than subjects without reflux: the mean difference in neonates, 4.65 mm; 1–6 months, 4.57 mm; 6–12 months, 3.61 mm.
Children with severe reflux had a shorter esophagus compared with those with mild and moderate reflux only in the neonate group. Therefore, thinking of GERD and carefully lookingfor its symptoms is necessary to avoid unnecessary utilization of healthcare resources in children with severe reflux.
Keywords: Abdominal esophagus length, barium meal, GERD, sonography
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o MATERIALS AND METHODS
Gastroesophageal reflux disease (GERD) can be defined as chronicsymptoms or mucosal damage secondary to abnormal reflux of gastric contents into the esophagus. According to Dent et al., the term GERD should be used to include all individuals who are exposed to the risk of physical complications from gastroesophageal reflux, or who experience clinically significant impairment of health-related well-being (quality of life) due to reflux-related symptoms, afteradequate reassurance of the benign nature of their symptoms.[2,3] The severity of sign and symptoms of gastroesophageal reflux disease (GERD) in children varies according to age.[4,5] GERD is the most common esophageal disorder and one of the most frequent diseases of the gastrointestinal tract in children and infants. GERD also is the most costly gastrointestinal disease in adults, andexisting data suggest that treatment costs in children are as high as adults.
GERD is a very common and usually benign physiological event in infants. A diagnosis of GERD is considered when gastroesophageal reflux is associated with presentations such as excessive irritability and crying, failure to thrive, feed refusal, apnea, and aspiration pneumonia. Many of these symptoms are not specific to...