Üst Gastrointestinal Sistem Floroskopi Yapılan Pediatrik Hastalarda Gastroözofageal Reflü Tanısını Etkileyen Faktörler

Abstract

Objective: The aim of this study was to evaluate the results of upper gastrointestinal fluoroscopy in infants and children and to investigate factors affecting results and the diagnosis of gastroesophageal reflux (GER). Material and Methods: Patients between the ages of 1 month and 18 years who underwent upper gastrointestinal fluoroscopy at the Radiology Department of Dr. Sami Ulus Research and Training Hospital between January 1, 2018 and December 31, 2018 were included in the study. The files of the patients were reviewed retrospectively. Results: Of the 76 patients who underwent upper gastrointestinal fluoroscopy, 46.1% were male and median age was 10 months. Among these, 2.6% (n=2) were diagnosed with mild GER, 18.4% (n=14) with moderate GER, and 38.2% (n=29) with severe GER. The accompanying anatomic pathologies were: malrotation (5.3%), operated esophageal atresia and diaphragmatic hernia (2.6%), organoaxial volvulus and prepyloric web (1.3%). Reasons of requesting upper gastrointestinal fluoroscopy were persistent vomiting in 40.8% (n=31), intermittent vomiting in 10.5% (n=8), and coughing in 11.8% (n=9). The most common accompanying pathologies were prematurity and growth retardation in 6.6% (n=5). 74.4% of those younger than 1 year of age were diagnosed with GER, while this percentage was 39.4% in those aged 1 year or older. The incidence of GER in patients younger than 1 year of age was found to be significantly higher (p=0.002). GER was present in 74.2% (n=23) of patients who had persistent vomiting, while it was present in 48.9% (n=22) of patients who underwent upper gastrointestinal fluoroscopy for other reasons. This difference was also statistically significant (p=0.027). Conclusion: In cases where gastroesophageal reflux disease is suspected, if the patient is younger than 1 year of age or has persistent vomiting, upper gastrointestinal fluoroscopy may be useful to confirm the diagnosis. However, anatomical disorder can be detected in very few of the recommended UGF. From this point of view, it would be more appropriate for clinicians to recommend UGF in more suitable cases considering radiation related risks and procedure difficulties.