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Barium study associated with water siphon test in gastroesophageal reflux disease and its complications

Lo studio baritato dell’esofago con water siphon test nella diagnosi di reflusso gastroesofageo e delle sue complicanze

  • Abdominal Radiology Radiologia Addominale
  • Published:
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Abstract

Purpose

The aim of this study was to evaluate the role of digital cineradiography associated with the water siphon test (WST) in the diagnosis of gastroesophageal reflux and to compare the results with oesophageal motility study, pH monitoring and endoscopy associated with biopsy and histology.

Materials and methods

One hundred and sixty consecutive patients underwent digital cineradiography with WST, motility study, pH monitoring and endoscopy with biopsy. The presence of gastroesophageal reflux, oesophagitis, Barrett’s oesophagus and intestinal metaplasia was evaluated.

Results

WST vs. pH monitoring showed sensitivity of 71%, specificity of 31%, positive predictive value (PPV) of 53% and negative predictive value (NPV) of 50%; when middle-proximal refluxes only were considered, sensitivity decreased to 45% and specificity increased to 55%. Furthermore, the association between reflux and oesophagitis demonstrated by the chi-square (χ2) test proved to be statistically significant both for WST and pH monitoring, whereas the association between reflux and Barrett’s oesophagus was not significant for either WST or for pH monitoring. With regard to intestinal metaplasia, WST (middle-proximal refluxes) showed higher sensitivity (64% vs. 58%) and specificity (63% vs. 51%) than pH monitoring, whereas the statistical association between reflux and metaplasia proved to be significant for WST but not for pH monitoring.

Conclusions

WST is a simple, inexpensive and reliable test that might be useful in the diagnosis of gastroesophageal reflux disease (GERD). A positive WST might be an additional indication for endoscopy with biopsy.

Riassunto

Obiettivo

Valutare il ruolo della videofluorografia con water siphon test (WST) nella diagnosi di reflusso gastroesofageo (GERD) comparandone i risultati con manometria, pH-metria ed endoscopia con biopsia e istologia.

Materiali e metodi

Centosessanta pazienti consecutivi sono stati sottoposti a videofluorografia digitale, manometria, pH-metria ed endoscopia con biopsia. È stata valutata la presenza di GERD, esofagite, esofago di Barrett e metaplasia intestinale.

Risultati

Il WST vs. pH-metria ha presentato sensibilità del 71%, specificità del 31%, valore predittivo positivo (PPV) del 53% e valore predittivo negativo (NPV) del 50%; la sua specificità aumenta (55%) considerando solamente i reflussi medioprossimali, ma diminuisce la sensibilità (45%). Inoltre l’associazione reflusso-esofagite (test del chi-quadro) è risultata statisticamente significativa sia per il WST che per la pH-metria, mentre l’associazione reflusso-Barret non è risultata statisticamente significativa né per WST né per pH-metria. Rispetto alla metaplasia intestinale, il WST (reflussi medioprossimali) ha sensibilità (64% vs. 58%) e specificità (63% vs. 51%) maggiori rispetto alla pH-metria; l’associazione statistica tra reflusso e metaplasia è risultata significativa per il WST ma non per la pH-metria.

Conclusioni

Il WST è un test semplice e poco costoso, facilmente realizzabile, che può essere utile nella diagnosi di GERD; la sua positività può essere un indicatore per selezionare i pazienti da avviare all’endoscopia con biopsia.

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Authors and Affiliations

  1. Department of Oncology, Surgical Unit, Università di Palermo, Policlinico Universitario, Via del Vespro 129, I-90127, Palermo, Italy

    E. Fiorentino, G. Pantuso & S. Latteri

  2. Department of Radiology “Domenico Noto”, Hospital of Sciacca, Via Pompei, I-92019, Sciacca, Italy

    F. Barbiera

  3. Department of Pathology, Università di Palermo, Policlinico Universitario, Via del Vespro 129, I-90127, Palermo, Italy

    D. Cabibi

  4. Department of Surgery, Università di Palermo, Policlinico Universitario, Via del Vespro 129, I-90127, Palermo, Italy

    S. Bonventre

  5. Department of Radiological Sciences, Università di Palermo, Policlinico Universitario, Via del Vespro 129, I-90127, Palermo, Italy

    A. Aiello & T. D’Agostino

Authors
  1. E. Fiorentino
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  2. F. Barbiera
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  3. D. Cabibi
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  4. G. Pantuso
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  5. S. Bonventre
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  6. A. Aiello
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  7. S. Latteri
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  8. T. D’Agostino
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Correspondence to F. Barbiera.

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Fiorentino, E., Barbiera, F., Cabibi, D. et al. Barium study associated with water siphon test in gastroesophageal reflux disease and its complications. Radiol med 112, 777–786 (2007). https://doi.org/10.1007/s11547-007-0190-0

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  • DOI: https://doi.org/10.1007/s11547-007-0190-0

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