Impaired gastric emptying in children with repaired esophageal atresia: a controlled study.
BACKGROUND
Scintigraphy is considered the "gold standard" for investigating gastric emptying. The lack of standards regarding registration technique and meal composition has been a problem especially in pediatric patients.


METHODS
In this study, gastric emptying of a solid meal was assessed by scintigraphy in 10 patients with repaired esophageal atresia (5 to 10 years old), and the results were compared with those in 11 healthy control children (5 to 11 years old). The meal consisted of pancakes with a fixed energy composition labeled with Tc-99m. Fractional meal retention values were plotted as a function of time.


RESULTS
Half-emptying time and lag phase values were longer in the patient group, whereas the emptying rate was slower and the retention values at 60 and 90 minutes were higher than in the control group. Extremely long lag phase and slow emptying rates were seen in two patients with reflux symptoms and abdominal complaints. Gastric emptying in healthy children has not previously been studied by scintigraphy. The results of this study show that values for gastric emptying of solids in healthy children correspond well to those reported in healthy adults.


CONCLUSIONS
Scintigraphy is an easy and reliable method for gastric emptying studies in children. The radioactive dose can be kept very low, which makes it a safe method even for pediatric patients. Delayed gastric emptying can occur in patients who have repaired esophageal atresia, and may be associated with reflux symptoms and abdominal complaints.
Montgomery
M
M
Department of Pediatric Surgery, St Göran's/Karolinska Hospital, Karolinska Institute, Stockholm, Sweden.
Escobar-Billing
R
R
Hellström
P M
PM
Karlsson
K A
KA
Frenckner
B
B
D002648:Child; D002675:Child, Preschool; D004933:Esophageal Atresia / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D013270:Stomach / Q000000981:diagnostic imaging