[Pulmonary gammagraphy study in asthmatic children with gastroesophageal reflux].
BACKGROUND
The asthmatic children who do not respond favorably to the specifically anti-allergic treatment, and also begin their breathlessness crisis preferably at night, are suspicious of suffering gastric-esophagus reflux that stimulate bronchial spasm crisis by means of an aspiration mechanism, or more frequently, by means of a reflective mechanism through the vagal via.


OBJECTIVE
To know probable physiopathologic mechanism of gastric-esophagus reflux that exacerbates asthmatic crisis. To know digestive symptoms associated to respiratory process. To evaluate clinic evolution of children after antireflux treatment.


METHODS
There were chosen 50 moderate-severe persistent asthmatic patients with non favorable evolution and gastric-esophagus reflux. The diagnosis was settled by means of radiological study, with barium contrast in esophagus, stomach and duodenum, and esophagus-pulmonary gammagraphy with technetium 99 (99mTc). Besides, a searching of bronchial aspiration signs with the isotopic exploration was carried out.


RESULTS
It was demonstrated that 38% of all cases had bronchial microaspirations and 30% did not have digestive symptoms associated to the respiratory process. Patients were subjected to an antireflux treatment and 78% of them considerably improved their asthmatic crisis after the treatment.


CONCLUSIONS
38% of the cases showed bronchial microaspirations in pulmonary gammagraphy. The more probable physiopathologic mechanism was vagal via, because 62% of the patients did not have bronchial aspiration signs. There were no digestive symptoms (silent reflux) in 30% of the children. Asthmatic crisis evolved favorably in 78% of the cases after antireflux treatment.
Cuevas Hernández
María Magdalena
MM
Hospital Pediátrico Docente de Centro Habana, Ciudad Habana, Cuba. asimonc@infomed.sld.cu
Arias Hernández
Rosa María
RM
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D001466:Barium Sulfate; D001986:Bronchial Spasm / Q000000981:diagnostic imaging* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003102:Colloids; D003131:Combined Modality Therapy; D003287:Contrast Media; D005260:Female; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D053120:Respiratory Aspiration / Q000000981:diagnostic imaging* / Q000209:etiology; D017556:Technetium Compounds; D017971:Tin Compounds; D014630:Vagus Nerve / Q000503:physiopathology*
D018927:Anti-Asthmatic Agents; D003102:Colloids; D003287:Contrast Media; D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D017971:Tin Compounds; C033493:technetium Tc 99m tin colloid; D001466:Barium Sulfate