Delayed gastric emptying and typical scintigraphic gastric curves in children with gastroesophageal reflux disease: Could pyloromyotomy improve this condition?

Tamara Caldaro, Maria Carmen Garganese, Filippo Torroni, Gianclaudio Ciofetta, Paola De Angelis, Giovanni Federici Di Abriola, Francesca Foschia, Francesca Rea, Erminia Romeo, Luigi Dall'Oglio

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Purposes: Delayed gastric emptying (DGE) is a cofactor in the etiopathogenesis of gastroesophageal reflux disease (GERD). Scintigraphy is the criterion standard to evaluate gastric emptying (GE). This study aims to define typical scintigraphic activity-time curves (ATCs) related to DGE and esophageal atresia (EA) and to demonstrate the effectiveness of pyloromyotomy (P) in improving GE. Methods: Since 2002, 83 children underwent Nissen fundoplication. Patients were divided into 2 groups: group I, GORD-only patients; group II, patients with GORD owing to OA. Depending on preoperative scintigraphy, each group was subdivided into 2 subgroups. Before surgery and 1 year after, endoscopy and scintigraphy were performed. In the presence of DGE, P was associated with Nissen fundoplication. Gastric emptying differences at baseline and at follow-up were estimated by the Student t test. Pre- and post-ATCs were evaluated by the χ 2 test. Results: During follow-up, GE completely normalized in subgroups with DGE. Scintigraphic ATC analysis documented an association between DGE and a typical rectilinear fitting, with a higher rate in OA patients. After P, the scintigraphic pattern changed in an exponential manner related to a faster GE. Conclusions: Delayed gastric emptying is frequent in OA, and the scintigraphic ATCs are typical. Pyloromyotomy is a safe and effective technique to fully normalize GE.

Original languageEnglish
Pages (from-to)863-869
Number of pages7
JournalJournal of Pediatric Surgery
Volume46
Issue number5
DOIs
Publication statusPublished - May 2011

Keywords

  • Delayed gastric emptying
  • Esophageal atresia
  • Gastric scintigraphy
  • Gastroesophageal reflux
  • Pyloromyotomy

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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