A functional study of caustic strictures of the esophagus in children.
The objective of the present study was to assess esophageal motor function in 21 children (7.5 +/- 2.9 years) with caustic strictures. Esophageal manometry was performed using a water-infusion system interfaced with a polygraph and displayed on a computer screen. The data were compared with those obtained from 9 healthy children. Radionuclide transit was determined by studying deglutition of a single bolus of 99mTc pertechnetate in 10 ml of water. Non-peristaltic low-amplitude and long-duration waves were the most common findings detected in patients with strictures longer than 20% of esophageal length (N = 11). Compared with the control group, these patients presented lower mean amplitude and longer mean duration of waves (24.4 +/- 11.2 vs 97.9 +/- 23.7 mmHg, P < 0.05, and 6.7 +/- 2.4 vs 1.6 +/- 0.1 s, P < 0.05, respectively). Six patients presented low-amplitude waves just below the constricted site. Ten children presented delayed esophageal transit. There was an association between dysphagia and abnormalities on manometry (P = 0.02) and between symptoms and scintigraphy data (P = 0.01). Dysphagia in caustic strictures is due to esophageal motility abnormalities, which are closely related to the scarred segment.
Da-Costa-Pinto
E A L
EA
Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de CampinasCampinas, SP, Brasil. elicostapinto@uol.com.br
Dorsa
T K
TK
Altimani
A
A
Andreollo
N A
NA
Cardoso
S R
SR
Morais
D J
DJ
Bustorff-Silva
J M
JM
D000293:Adolescent; D002057:Burns, Chemical / Q000209:etiology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D015154:Esophageal Motility Disorders / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004940:Esophageal Stenosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008365:Manometry / Q000379:methods; D011877:Radionuclide Imaging; D012720:Severity of Illness Index; D012972:Sodium Hydroxide / Q000633:toxicity*
D012972:Sodium Hydroxide