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Gastroesophageal reflux: radiological aspects

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Abstract

Numerous recent diagnostic methods have made gastro-esophageal reflux (GER) a significant challenge for the clinician. We report our experience with radiologic studies in 1188 children, 352 of whom also underwent esophageal manometry. Radiologic examination is the least sensitive method of demonstrating reflux, but has the advantage of detecting anatomic malformations and upper gastrointestinal obstruction. The success rate is more than doubled when the water siphon test is also used. The X-ray signs and classification of reflux are described. Reflux scintigraphy is a very sensitive and highly specific technique that is especially suitable when pulmonary lesions are suspected or for follow-up after therapy. Another noninvasive procedure involving no radiation exposure is ultrasonography. The results of various concurrent methods, including esophageal manometry and pH determinations, are compared. The association of reflux with pyloric stenosis brachyesophagus, peptic esophageal stenosis, and 13 other disorders is discussed and a plea made for drastic reduction of the use of X-ray studies in GER. The indication for using mechanical devices must be made subjectively in each individual case depending upon the clinical symptoms, the equipment available, and the experience of the physician.

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  1. Department of Radiology, Universitäts-Kinderklinik, Im Neuenheimer Feld 150, D-6900, Heidelberg, Federal Republic of Germany

    E. Willich

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Willich, E. Gastroesophageal reflux: radiological aspects. Pediatr Surg Int 1, 144–160 (1986). https://doi.org/10.1007/BF00180916

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