title: Esophageal atresia: gastroesophageal functional follow-up in 5-15 year old children.
abstract: OBJECTIVE
  Esophageal atresia (EA) is one of the most frequent congenital alimentary tract anomalies with a considerable morbidity throughout childhood. This study evaluates the gastroesophageal problems in 5-15 year old children with EA and aims to identify factors predisposing to esophagitis in EA.
  
  
  METHODS
  Fifty-nine patients primarily operated at Odense University Hospital, Denmark, during 1993-2005 were included in this follow-up study. The patients underwent the following examinations: Interview, upper endoscopy, endoscopic ultrasonography, high-resolution esophageal manometry (HREM), and pH- and multichannel intraluminal impedance (MII) measurements. Twenty-five patients with suspected gastro-esophageal reflux disease (GERD) underwent the same investigations and served as controls.
  
  
  RESULTS
  Median age was 10.2 years (7.1-13.3). Thirty-three (55.9%) presented with GERD symptoms, 41 (69.5%) with dysphagia, and 33 (55.9%) with respiratory symptoms. Twenty-nine (49.2%) had endoscopic esophagitis, and 26 (44.1%) histological esophagitis. Median reflux index (RI) was 8.3 (4.8-14.9). In 32 (55.2%) RI was above 7. Ten percent had eosinophilic inflammation. HREM showed dysmotility in the esophagus in all EA patients, 83.3% had no propagating swallows. No predictive factors predisposing the development of endoscopic esophagitis were identified.
  
  
  CONCLUSIONS
  Gastroesophageal problems in children born with EA are common. Routine follow-up with endoscopy and pH-metry in EA patients is warranted.
authors: Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark. Electronic address: rnp@dadlnet.dk.
authors: Rikke Neess
authors: RN
authors: Pedersen
authors: Simone
authors: S
authors: Markøw
authors: Søren
authors: S
authors: Kruse-Andersen
authors: Niels
authors: N
authors: Qvist
authors: Tine Plato
authors: TP
authors: Hansen
authors: Oke
authors: O
authors: Gerke
authors: Rasmus Gaardskær
authors: RG
authors: Nielsen
authors: Lars
authors: L
authors: Rasmussen
authors: Steffen
authors: S
authors: Husby
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D019160:Endosonography; D004933:Esophageal Atresia / Q000601:surgery*; D015154:Esophageal Motility Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D050782:Esophageal pH Monitoring; D004941:Esophagitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008365:Manometry; D015999:Multivariate Analysis; D010992:Plethysmography, Impedance; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies
keywords: Children; Esophageal atresia; Esophageal motility disorders; Gastroesophageal reflux disease; High resolution esophageal manometry; Upper endoscopy