[Gastroesophageal reflux in infants: ultrasonographic reading of pHmetry].
BACKGROUND
pH monitoring of the distal esophagus has proved both sensitive and specific in the detection of reflux but has several limitations due to changes over time in esophageal pH and possibility of alkaline reflux. Simultaneous ultrasonographic monitoring can be helpful when interpreting the results.


METHODS
One thousand infants (80% under 1 year of age) were examined: 500 suffered from vomiting (310 patients), life-threatening events (65 patients) or repeated respiratory diseases (125 patients). Five hundred infants were controls (320 asymptomatic and 180 sibs of patients with SIDS). pHmonitoring and ultrasonography were performed before and after ingestion of milk by vomiting patients and after administration of orange juice in the other symptomatic patients. Control patients were given milk when asymptomatic or orange juice when they belonged to a SIDS sibship.


RESULTS
Ultrasonography permitted to interpret the different phases of the pH curves according to the age of patients, the meals and their nature, the events associated with temporary increase in abdominal pressure, the gravity. pH monitoring was able to recognize 1589 acid reflux but failed to recognize 2091 reflux episodes.


CONCLUSIONS
While pHmonitoring is helpful to demonstrate a relationship between the reflux and such events as apnea, bradycardia, cough, ultrasonography defines a risk based on specificity of reflux and laryngeal or esophageal dysfunction.
Gomes
H
H
Service de radiopédiatrie, American Memorial Hospital, Reims, France.
D004942:Esophagitis, Peptic / Q000000981:diagnostic imaging / Q000503:physiopathology; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D014463:Ultrasonography
Reflux gastrooesophagien du nourrisson: lecture échographique de la pHmétrie.