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    Go to the top of the page   ID: 20011017191947 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Gastroesophageal reflux (1)
    H Teichler. Gastroesophageal reflux (1). PedRad [serial online] vol 1, no. 10.
    URL: www.PedRad.info/?search=20011017191947


    ( There are questions in the CMK-Mode for this topic )

     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    H. Teichler (Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    N/A  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    GI-Esophagus  

     
     Pediatric Radiology CasesMost likely etiology:

    other  

     
     Pediatric Radiology CasesHistory:

    Multiple signs are possible, i.e. reoccuring vomiting, loss of weight, reoccuring respiratory illnesses, esophagitis. An anemia through hemorrhagic esophagitis has been described, although seldom. Retrosternal pain ("heartburn").  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Incompetence of the cardiac orifice of the stomach (through low closing pressure, the severe form is designated as cardiochalasia).

    Hernia (fixed or gliding), axial or paraaxial. The severest form of a paraaxial hernia is an upside-down stomach in the thorax, which we saw in connective tissue weakness (i.e. Arthrogryposis congenita) twice.

    Brachyesophagus (innate or acquired due to an inflammation or acquired after surgery).

    His-angle remains > 90° after surgery for the esophageal atresia  

     
     Pediatric Radiology CasesRadiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Representation of the normal anatomy when cardia is closed.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: B-image: Reflux of gastric contents (tea) in the distal esophagus.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Color doppler: the flow towards the receiver (orthograde esophageal passage) is coded in red.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Color doppler: Reflux of gastric contents in the esophagus is coded as blue. The use of the color doppler only brings advantages in devices with optimal settings. Normally the B-image representation suffices.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Total constellation (Consens)  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Secondary reflux in hypertrophic pylorus stenosis: Roviralta syndrome.
    Brachyesophagus  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    In infancy, often spontaneous improvement ("Cure")

    In case of a fixated hernia, only surgical intervention is successful.  

     
     Pediatric Radiology CasesComments of the author about the case:

    Refluxes occur often, but are also often without significance.

    We complete about 1-2 reflux sonographies per day. Only in higher staged reflux (>3 refluxes per 10 minutes) do we do an x-ray examination. The children must be very quiet. A gastric tube must be placed on the ward. It is used to give children an appropriate amount of tea.

    Observation time: 10 minutes. The first minute after tube removal is not counted.

    Hernias (x-ray) are in our clinic seldom (about 5 per year).

    Classification:
    0-2 Reflux periods in 10 minutes is normal to borderline = Grade I

    3-5 Refluxes per 10 minutes = Grade II

    More than 6 refluxes per 10 minutes = Grade III


    X-ray: An x-ray representation can be used in Grade II or above (hiatal hernia?). If one doesn't have reflux in the 10 minutes, doesn't have a hernia, which can be shown in that short amount of time.

    The number of necessary x-rays is therefore reduced.

    In x-ray imaging, the hiatal hernia can be fixated or moveable. Careful: It is not the esophageal vestibulum that you should see as the hernia: it is the position of the schatzki ring and the diaphragmatic tightness.


     

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Hirsch W, R Kedar, U Preiß
    Color Doppler in the Diagnosis of the gastroesophageal reflux in children: comparison with pH measurements and B-mode ultrasound.
    Pediatr Radiol 26 (1996), 232-235  

     
     Pediatric Radiology CasesKeywords:

    Reflux, Gastroesophageal, Esophagus, GERD, Gastroesophageal reflux disease, heartburn, recurrent vomiting, weight loss, recurrent respiratory illnesses, esophagitis, anemia, hiatal hernia, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    H Teichler. Gastroesophageal reflux (1). PedRad [serial online] vol 1, no. 10.
    URL: www.PedRad.info/?search=20011017191947  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: GI-Esophagus
    or in the region: GI
    or in the tissue/organ: Esophagus
    or with the etiology: other
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Gastroesophageal reflux (1)
    H Teichler. Gastroesophageal reflux (1). PedRad [serial online] vol 1, no. 10.
    URL: www.PedRad.info/?search=20011017191947


    ( There are questions in the CMK-Mode for this topic )

     

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    Gastroesophageal reflux (1)
    Other cases by these authors:

    Search H. Teichler  in Medline H. Teichler (4)   

    Gastroesophageal reflux (1)  
     
    Gastroesophageal reflux (1)
    H Teichler. Gastroesophageal reflux (1). PedRad [serial online] vol 1, no. 10.
    URL: www.PedRad.info/?search=20011017191947


    ( There are questions in the CMK-Mode for this topic )

     
     
    Gastroesophageal reflux (1)
    H Teichler. Gastroesophageal reflux (1). PedRad [serial online] vol 1, no. 10.
    URL: www.PedRad.info/?search=20011017191947


    ( There are questions in the CMK-Mode for this topic )

     

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    Gastroesophageal reflux (1)
    H Teichler. Gastroesophageal reflux (1). PedRad [serial online] vol 1, no. 10.
    URL: www.PedRad.info/?search=20011017191947


    ( There are questions in the CMK-Mode for this topic )

     




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