Role of Esophageal High-Resolution Manometry in Pediatric Patients
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Purpose: Dysphagia, vomiting and feeding difficulties are common symptoms, with which children present. Esophageal function testing with high resolution manometry can help in diagnosing and treating these patients. We aim to access the clinical utility of high-resolution manometry of esophagus in symptomatic pediatric patients. Methods: A retrospective chart review was done on all symptomatic patients who underwent esophageal high-resolution manometry between 2010 and 2019 at Sydney Children’s Hospital, Australia. Manometry results were categorized based on Chicago classification. Demographic data, indication of procedure, manometric findings, and details of treatment changes were obtained and analyzed. Results: There were 62 patients with median age of 10 years (9 months–18 years). The main indication for the procedure was dysphagia (56%). Thirty-two percent of patients had a co-morbid condition, with esophageal atresia accounting for 16%. The majority (77%) of patients had abnormal manometry which included, ineffective esophageal motility in 45.2%. In esophageal atresia cohort, esophageal pressurization was seen in 50%, aperistalsis in 40% and 10% with prior fundoplication had esophago-gastric junction obstruction. Patients with esophago-gastric junction obstruction or achalasia were treated by either pneumatic dilation or Heller’s myotomy. Patients with ineffective esophageal motility and rumination were treated with a trial of prokinetics/dietary texture modification and diaphragmatic breathing. Conclusion: Esophageal high-resolution manometry has a role in the evaluation of symptomatic pediatric patients. The majority of our patients had abnormal results which led to change in treatments, with either medication, surgery and/or feeding modification with resultant improvement in symptoms.
Abstract
Purpose: Dysphagia, vomiting and feeding difficulties are common symptoms, with which children present. Esophageal function testing with high resolution manometry can help in diagnosing and treating these patients. We aim to access the clinical utility of high-resolution manometry of esophagus in symptomatic pediatric patients. Methods: A retrospective chart review was done on all symptomatic patients who underwent esophageal high-resolution manometry between 2010 and 2019 at Sydney Children’s Hospital, Australia. Manometry results were categorized based on Chicago classification. Demographic data, indication of procedure, manometric findings, and details of treatment changes were obtained and analyzed. Results: There were 62 patients with median age of 10 years (9 months–18 years). The main indication for the procedure was dysphagia (56%). Thirty-two percent of patients had a co-morbid condition, with esophageal atresia accounting for 16%. The majority (77%) of patients had abnormal manometry which included, ineffective esophageal motility in 45.2%. In esophageal atresia cohort, esophageal pressurization was seen in 50%, aperistalsis in 40% and 10% with prior fundoplication had esophago-gastric junction obstruction. Patients with esophago-gastric junction obstruction or achalasia were treated by either pneumatic dilation or Heller’s myotomy. Patients with ineffective esophageal motility and rumination were treated with a trial of prokinetics/dietary texture modification and diaphragmatic breathing. Conclusion: Esophageal high-resolution manometry has a role in the evaluation of symptomatic pediatric patients. The majority of our patients had abnormal results which led to change in treatments, with either medication, surgery and/or feeding modification with resultant improvement in symptoms.
참고문헌 (37)
- Nurko S, "Walker’s pediatric gastrointestinal disease:pathophysiology, diagnosis, management" (2018), People’s Medical Publishing House
- Chumpitazi B, "Pediatric gastrointestinal motility disorders: challenges and a clinical update", Gastroenterol Hepatol (N Y), 4, pp.140~148 (2008)
- Rommel N, "The potential benefits of applying recent advances in esophageal motility testing in patients with esophageal atresia", Front Pediatr, 5, pp.137~ (2017)
- Rommel N, "High-resolution manometry combined with impedance measurements discriminates the cause of dysphagia in children", Eur J Pediatr, 174, pp.1629~1637 (2015)
- Hsing TY, "Role of esophageal manometry in children with refractory gastroesophageal reflux symptoms", Pediatr Int, 61, pp.807~811 (2019)
- Kahrilas PJ, "The Chicago Classification of esophageal motility disorders, v3.0", Neurogastroenterol Motil, 27, pp.160~174 (2015)
- Papadopoulou A, "Management guidelines of eosinophilic esophagitis in childhood", J Pediatr Gastroenterol Nutr, 58, pp.107~118 (2014)
- Pilic D, "Detection of gastroesophageal reflux in children using combined multichannel intraluminal impedance and pH measurement : data from the German Pediatric Impedance Group", J Pediatr, 158, pp.650~654 (2011)[DOI]
- Edeani F, "Characterization of esophageal motility disorders in children presenting with dysphagia using high-resolution manometry", Curr Gastroenterol Rep, 19, pp.13~ (2017)
- Gyawali CP, "Evaluation of esophageal motor function in clinical practice", Neurogastroenterol Motil, 25, pp.99~133 (2013)
- Zerbib F, "Oesophageal dysphagia : manifestations and diagnosis", Nat Rev Gastroenterol Hepatol, 12, pp.322~331 (2015)
- Halland M, "Correlation between the radiological observation of isolated tertiary waves on an esophagram and findings on high-resolution esophageal manometry", Dis Esophagus, 29, pp.22~26 (2016)
- von Arnim U, "Correlation of high-resolution manometric findings with symptoms of dysphagia and endoscopic features in adults with eosinophilic esophagitis", Dig Dis, 35, pp.472~477 (2017)
- Ott DJ, "Esophageal radiography and manometry : correlation in 172 patients with dysphagia", AJR Am J Roentgenol, 149, pp.307~311 (1987)
- Takahisa Yamasaki, "Esophagography in Patients With Esophageal Achalasia Diagnosed With High-resolution Esophageal Manometry", Journal of Neurogastroenterology and Motility (JNM), 24(3), pp.403~407 (2018), 대한소화기 기능성질환∙운동학회[DOI]
- Schima W, "Esophageal motor disorders : videofluoroscopic and manometric evaluation--prospective study in 88 symptomatic patients", Radiology, 185, pp.487~491 (1992)
- Singendonk MM, "Applying the Chicago Classification criteria of esophageal motility to a pediatric cohort : effects of patient age and size", Neurogastroenterol Motil, 26, pp.1333~1341 (2014)
- 홍지나, "Clinical Applications of Gastrointestinal Manometry in Children", Pediatric Gastroenterology, Hepatology & Nutrition, 17(1), pp.23~30 (2014), 대한소아소화기영양학회
- Juzaud M, "Correlation between clinical signs and high-resolution manometry data in children", J Pediatr Gastroenterol Nutr, 68, pp.642~647 (2019)
- Singendonk MMJ, "High-resolution esophageal manometry in pediatrics : effect of esophageal length on diagnostic measures", Neurogastroenterol Motil, 32, pp.e13721~ (2020)
- Goldani HA, "Pediatric esophageal high-resolution manometry : utility of a standardized protocol and size-adjusted pressure topography parameters", Am J Gastroenterol, 105, pp.460~467 (2010)
- Staiano A, "Segmental characteristics of oesophageal peristalsis in paediatric patients", Neurogastroenterol Motil, 20, pp.19~26 (2008)
- Rosen JM, "Diffuse esophageal spasm in children referred for manometry", J Pediatr Gastroenterol Nutr, 56, pp.436~438 (2013)
- Reas DL, "Is it an eating disorder or achalasia or both? A literature review and diagnostic challenges", Eur Eat Disord Rev, 22, pp.321~330 (2014)
- van Lennep M, "Clinical management of pediatric achalasia", Expert Rev Gastroenterol Hepatol, 12, pp.391~404 (2018)
- Hallal C, "Diagnosis, misdiagnosis, and associated diseases of achalasia in children and adolescents : a twelve-year single center experience", Pediatr Surg Int, 28, pp.1211~1217 (2012)
- Nikaki K, "Rumination syndrome in children presenting with refractory gastroesophageal reflux symptoms", J Pediatr Gastroenterol Nutr, 70, pp.330~335 (2020)
- Krishnan U, "ESPGHAN-NASPGHAN guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with esophageal atresia-tracheoesophageal fistula", J Pediatr Gastroenterol Nutr, 63, pp.550~570 (2016)
- Lemoine C, "Characterization of esophageal motility following esophageal atresia repair using high-resolution esophageal manometry", J Pediatr Gastroenterol Nutr, 56, pp.609~614 (2013)
- Faure C, "Dysmotility in esophageal atresia : pathophysiology, characterization, and treatment", Front Pediatr, 5, pp.130~ (2017)
- Gottrand M, "Motility, digestive and nutritional problems in Esophageal Atresia", Paediatr Respir Rev, 19, pp.28~33 (2016)
- Tong S, "Evaluation of gastroesophageal reflux by combined multichannel intraluminal impedance and pH monitoring and esophageal motility patterns in children with esophageal atresia", Eur J Pediatr Surg, 26, pp.322~331 (2016)
- Aspirot A, "Esophageal dysmotility : characterization and pathophysiology", Dis Esophagus, 26, pp.405~409 (2013)
- Gockel I, "Before and after esophageal surgery : which information is needed from the functional laboratory?", Visc Med, 34, pp.116~121 (2018)
- Loots C, "Gastroesophageal reflux, esophageal function, gastric emptying, and the relationship to dysphagia before and after antireflux surgery in children", J Pediatr, 162, pp.566~573 (2013)[DOI]
- Gariepy CE, "Clinical management of motility disorders in children", Semin Pediatr Surg, 18, pp.224~238 (2009)
- Singendonk MM, "Inter-and intrarater reliability of the Chicago Classification in pediatric high-resolution esophageal manometry recordings", Neurogastroenterol Motil, 27, pp.269~276 (2015)