Transcutaneous Esophageal Ultrasonography in Children with Suspected Gastroesophageal Reflux Disease
Busara Charoenwat MD1, Palittiya Sintusek MD1, Nataruks Chaijitraruch MD1, Atchara Mahayosnond MD2, Sukuma Suksri RN3, Tanisa Patcharatrakul MD3, Voranush Chongsrisawat MD1,3
Affiliation : 1 Division of Gastroenterology and Hepatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 2 Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 3 Center of Excellence for Neurogastroenterology and Motility, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective : To evaluate the esophageal morphological parameters and occurrence of refluxate using transcutaneous esophageal
ultrasonography [US] in children with suspected gastroesophageal reflux disease [GERD].
Materials and Methods : Twenty-two children with suspected GERD and 23 healthy controls were enrolled during November
2015 to January 2017. GERD was defined as reflux index and/ or liquid refluxate evaluated by multichannel intraluminal
impedance-pH (MII-pH) monitoring greater than the 95th percentile of age-specific values. All subjects underwent
transcutaneous esophageal US to assess the occurrence of refluxate and the esophageal morphology.
Results : Median age of patients (50% male) and controls (57% male) were 1.6 years (interquartile range 0.6 to 5 years) and
1.7 years (interquartile range 0.5 to 7.5 years), respectively. GERD symptoms were divided into esophageal (n = 11) and
extraesophageal (n = 11) manifestations. Occurrence of refluxate and esophageal morphological parameters detected by
transcutaneous esophageal US were not different between study and control groups. However, study group tended to have
shorter abdominal esophageal length compared with controls (16.8+4.3 mm vs. 18.2+6.5 mm). Study group with GERD
confirmed by MII-pH monitoring (n = 6) tended to have higher cervical/ abdominal esophageal wall thickness and diameter,
and degree of gastroesophageal angle than those with normal MII-pH monitoring (n = 16), however the differences were not
statistically significant. The number of occurrence of refluxate identified by transesophageal US was not significantly
different between study group with and without abnormal refluxate detected by MII-pH monitoring.
Conclusion : The number of occurrence of refluxate and esophageal morphology evaluated by transcutaneous esophageal US
do not correlate well with the MII-pH monitoring results.
Keywords : Children, Combined multichannel intraluminal impedance-pH monitoring, Gastroesophageal reflux disease, Transcutaneous esophageal ultrasonography
