Intragastric maldistribution of a liquid meal in children with recurrent abdominal pain assessed by three-dimensional ultrasonography.
BACKGROUND
Using two-dimensional (2D) ultrasonography, we previously found indications of impaired adaptive relaxation of the proximal stomach in children with recurrent abdominal pain (RAP). In the present study, we applied a new three-dimensional (3D) ultrasonographic method to investigate intragastric volumes and distribution of a liquid meal in another group of children with RAP.


METHODS
Twenty patients with RAP (age 10-15 years) and 20 healthy subjects (age 11-15 years) underwent ultrasonographic measurements of the stomach. A position sensor was used based on magnetic scanhead tracking for acquisition of 3D images after a liquid meal. The children scored abdominal symptoms before and after the meal.


RESULTS
Expressed as a fraction of ingested volume, the patients had a smaller volume of the proximal stomach and a larger antral volume at 2 min postprandially compared to healthy subjects (P = 0.03 and P = 0.001, respectively). The patients also showed a decreased proximal to distal gastric volume ratio at 2 min postprandially (P = 0.001). Patients experienced more pain in response to the meal than healthy subjects (P = 0.04), but there was no correlation between pain and proximal or distal gastric volumes.


CONCLUSIONS
RAP in children may be associated with an early intragastric maldistribution of a meal.
Olafsdottir
E
E
Dept. of Paediatrics and Institute of Medicine, University of Bergen, Norway. edda.olafsdottir@helse_bergen.no
Gilja
O H
OH
Tefera
S
S
Fluge
G
G
Berstad
A
A
D015746:Abdominal Pain / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D000293:Adolescent; D002648:Child; D005260:Female; D005502:Food; D005766:Gastrointestinal Contents; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D010147:Pain Measurement; D019518:Postprandial Period / Q000502:physiology; D012008:Recurrence; D013270:Stomach / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography