Üst Gastrointestinal Sistem Floroskopi Yapılan Pediatrik Hastalarda Gastroözofageal Reflü Tanısını Etkileyen Faktörler

Yıl 2020, , 268 - 273, 29.05.2020

Çiğdem Üner , Ayşe Ekşioğlu

https://doi.org/10.12956/tchd.674172

Öz

Amaç: Bu
çalışmanın amacı bebeklerde ve çocuklarda üst gastrointestinal floroskopi
sonuçlarını değerlendirmek, sonuçları etkileyen faktörleri ve gastroözofageal
reflü (GÖR) tanısını araştırmaktır.

Yöntemler: Dr.
Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma
Hastanesi Pediatrik Radyoloji Bölümü'nde 1 Ocak 2018 ile 31 Aralık 2018
tarihleri arasında üst gastrointestinal sistem floroskopisi  uygulanan 1 aylık ile 18 yaş arasındaki
hastalar çalışmaya dahil edildi. Hastaların dosyaları retrospektif olarak
incelendi.

Bulgular: Üst
gastrointestinal sistem floroskopisi yapılan 76 hastanın% 46.1'i erkek, ortanca
yaşı 10 aydı. Bunların% 2.6'sına (n=2) hafif GÖR,% 18.4'ü (n=14) orta GÖR ve%
38.2'si (n=29) şiddetli GÖR tanısı konuldu. Eşlik eden anatomik patolojiler
şunlardı: malrotasyon (% 5.3), opere özofagus atrezisi ve diyafragma hernisi (%
2.6), organoaksiyel volvulus ve preplorik veb (% 1.3). Üst gastrointestinal floroskopi
istem nedenleri% 40.8 (n=31) 'de dirençli  kusma,% 10.5 (n=8)' de aralıklı kusma ve% 11.8
(n=9) öksürüktü. En sık eşlik eden patolojiler % 6.6'da (n=5) prematürite ve
büyüme geriliği idi. 1 yaşından küçüklerin% 74.4'üne GÖR tanısı konulurken, bu
oran 1 yaş ve üstü çocuklarda % 39.4 idi. 1 yaşından küçük hastalarda GÖR
görülme sıklığı anlamlı derecede yüksek bulundu (p=0.002). Sürekli kusma olan
hastaların % 74.2'sinde (n=23) GÖR, diğer nedenlerle üst gastrointestinal floroskopi
uygulanan hastaların % 48.9'unda (n=22) GÖR mevcuttu. Bu fark da istatistiksel
olarak anlamlıydı (p=0.027).

Sonuç: Gastroözofageal
reflü hastalığından şüphelenilen durumlarda, hasta 1 yaşından küçükse veya
sürekli kusma varsa, üst gastrointestinal sistem floroskopisi  tanıyı doğrulamak için yararlı olabilir. Bununla
birlikte, anatomik bozukluklar önerilen UGF'lerin çok azında tespit edilebilmiştir.
Bu bakış açısından, klinisyenlerin radyasyona bağlı riskler  ve prosedür zorlukları göz önünde bulundurularak
  UGF'yi önermeleri uygun olacaktır.

Anahtar Kelimeler

Gastrointestinal Sistem, Üst Gastrointestinal Endoskopi, Gastroözofageal Reflü

Factors Affecting The Diagnosis Of Gastroesophageal Reflux In Pediatric Patients Undergoing Upper Gastrointestinal Fluoroscopy

Öz

Objective:
The aim of this
study was to evaluate the results of upper gastrointestinal fluoroscopy in
infants and children and to investigate factors affecting results and the
diagnosis of gastroesophageal reflux (GER).

Material
and Methods: Patients
between the ages of 1 month and 18 years who underwent upper gastrointestinal fluoroscopy
at the Radiology Department of Dr. Sami Ulus Research and Training Hospital
between January 1, 2018 and December 31, 2018 were included in the study. The
files of the patients were reviewed retrospectively.

Results:
Of the 76 patients
who underwent upper gastrointestinal fluoroscopy, 46.1% were male and median
age was 10 months. Among these, 2.6% (n=2) were diagnosed with mild GER, 18.4%
(n=14) with moderate GER, and 38.2% (n=29) with severe GER. The accompanying
anatomic pathologies were: malrotation (5.3%), operated esophageal atresia and
diaphragmatic hernia (2.6%), organoaxial volvulus and prepyloric web (1.3%).
Reasons of requesting upper gastrointestinal fluoroscopy were persistent
vomiting in 40.8% (n=31), intermittent vomiting in 10.5% (n=8), and coughing in
11.8% (n=9). The most common accompanying pathologies were prematurity and
growth retardation in 6.6% (n=5). 74.4% of those younger than 1 year of age
were diagnosed with GER, while this percentage was 39.4% in those aged 1 year
or older. The incidence of GER in patients younger than 1 year of age was found
to be significantly higher (p=0.002). GER was present in 74.2% (n=23) of
patients who had persistent vomiting, while it was present in 48.9% (n=22) of
patients who underwent upper gastrointestinal fluoroscopy for other reasons.
This difference was also statistically significant (p=0.027).

Conclusion:
In cases where
gastroesophageal reflux disease is suspected, if the patient is younger than 1
year of age or has persistent vomiting, upper gastrointestinal fluoroscopy may
be useful to confirm the diagnosis. However, anatomical disorder can be detected in very
few of the recommended UGF. From this point of view, it would be more
appropriate for clinicians to recommend UGF in more suitable cases considering radiation
related risks  and procedure
difficulties.

Anahtar Kelimeler

Gastrointestinal System, Upper Gastrointestinal Endoscopy, Gastroesophageal Reflux

Kaynakça

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