Top

Pediatric Radiology

Published in:

01-08-2003 | Original Article

Ultrasonography and gastric emptying in children: validation of a sonographic method and determination of physiological and pathological patterns

Authors: Hélène Gomes, Patricia Hornoy, Jean Claude Liehn

Published in: Pediatric Radiology | Issue 8/2003

Abstract

Background

The association between gastric emptying and gastro-esophageal reflux (GER) has been widely recognised from scintigraphic studies.

Objective

A prospective study to (a) validate US as a means of measuring gastric emptying, (b) determine physiological patterns of gastric emptying and (c) measure gastric emptying in symptomatic refluxers.

Materials and methods

Three cohorts were studied: (a) Ten babies in whom gastric emptying was measured by US and scintigraphy; (b) gastric emptying in 330 asymptomatic children aged between 15 days and 10 years to determine physiological variations; and (c) gastric emptying in 552 children with GER, manifesting as vomiting or cardiorespiratory problems.

Results

US and scintigraphic techniques showed general concordance in 90% of cases. In the remaining 10%, discordant results were related to overlapping of duodenum and stomach during scintigraphy and shadowing of the gastric antrum by air during US. Tremendous variations were induced by change of feed volume or type of formula, underlining the need for a standardised procedure. Twenty-two percent of cases showed a peculiar 'plateau' which differed significantly from the physiological patterns. Most of these babies had esophagitis or acute life-threatening events.

Conclusions

Investigation of gastric emptying seems to be a key element in the assessment of children with 'pathological' GER. US is a safe and cheap alternative to scintigraphy for the assessment of gastric emptying.

Jolley SG, Leonard JC, Tunnell WP (1987) Gastric emptying in children with gastroesophageal reflux: an estimate of effective gastric emptying. J Pediatr Surg 22:923–927PubMed

Hillemeier AC, Lange R, McCallum R, et al (1981) Delayed gastric emptying in infants with gastroesophageal reflux. J Pediatr 98:190–193PubMed

De Salamanca FE (1949) Estudio de fisiologia gastrica. Arch Med Exp. 3:17–23

Hunt JN, Spurrell WR (195 l) The pattern of emptying of the human stomach. J Physiol 113:157–165

Griffith GH, Owen GM, Kirkman S, et al (1966) Measurement of rate of gastric emptying using chromium 51. Lancet 1:1244–1250PubMed

Signer E, Fridrich R (1975) Gastric emptying in newborns and young infants. Measurement of the rate of emptying using indium 113m microcolloid. Acta Paediatr Scand 64:525–530PubMed

Seibert JJ, Byrne WJ, Euler AR (1983) Gastric emptying in children: unusual patterns detected by scintigraphy. AJR 141:49–51

Sty JR, Starshak RJ (1982) The role of radionuclide studies in pediatric gastrointestinal disorders. Semin Nucl Med 12:156–172PubMed

Bateman DN, Whittingham TA (1982) Measurement of gastric emptying by real-time ultrasound. Gut 23:524–527PubMed

10.

LiVoti G, Tulone V, Bruno R, et al (1992) Ultrasonography and gastric emptying: evaluation in infants with gastroesophageal reflux. J. Pediatr Gastroenterol Nutr 14:397–399

11.

Lambrecht L, Robberecht E, Deschynkel, et al (1988) Ultrasonic evaluation of gastric clearing in young infants. Pediatr Radiol 18:314–318PubMed

12.

Bolondi L, Bortolotti M, Santi V, et al (1985) Measurement of gastric emptying time by real-time ultrasonography. Gastroenterology 89:752–759PubMed

13.

Newell SJ, Chapman S, Booth IW (1993) Ultrasonic assessment of gastric emptying in the preterm infant. Arch Dis Child 69:32–36PubMed

14.

Marzio L, Giacobbe A, Conoscitore P, et al (1989) Evaluation of the use of ultrasonography in the study of liquid gastric emptying. Am J Gastroenterol 84:496–500PubMed

15.

Gomes H, Menanteau B (1991) Gastro-esophageal reflux: comparative study between sonography and pH monitoring. Pediatr Radiol 21:168–174PubMed

16.

Dapoigny M, Bonnafous J, Delasalle P, et al (1991) Validation of an ultrasonographic method of gastric emptying measurement in men (in French). Gastroenterol Clin Biol 15:199–203PubMed

17.

Cucchiara S, Raia V, Minella R, et al (1996) Ultrasound measurement of gastric emptying time in patients with cystic fibrosis and effect of ranitidine on delayed gastric emptying. J Pediatr 128:485–488PubMed

18.

Arienti V, Magri F, Boriani L, et al (1994) Effect of a single dose of oral erythromycin on gastric and gallbladder emptying. Simultaneous assessment by ultrasound. Dig Dis Sci 39:1309–1312PubMed

19.

Blumenthal I, Ebel A, Pildes R (1979).Effect of posture on the pattern of stomach emptying in the newborn. Pediatrics 63:532–536PubMed

20.

Fried MD, Khoshoo V, Secker DJ, et al (1992) Decrease in gastric emptying time and episodes of regurgitation in children with spastic quadriplegia fed with whey-based formula. J Pediatr 120:569–572PubMed

21.

Hveem K, Jones KL, Chatterton BE, et al (1996) Scintigraphic measurement of gastric emptying and ultrasonographic assessment of antral area: relation to appetite. Gut 38:816–821PubMed

22.

Brown BP, Ketelaar MA, Schuize-Deirieu K, et al (1994) Strenuous exercise decreases motility and cross-sectional area of human gastric antrum. A study using ultrasound. Dig Dis Sci 39:940–945PubMed

23.

Villanueva-Meyer J, Swischuk LE, Cesani F, et al (1996) Pediatric gastric emptying: value of the right lateral and upright positioning. J Nucl Med 37:1356–1358PubMed

24.

Van Nieuvenhoven MA, Brouns F, Brummer RJ (1999) The effect of physical exercise on parameters of gastrointestinal function. Neurogastroenterol Motil 11:431–439CrossRefPubMed

25.

Sutphen JL, Dillard VL (1988) Effect of feeding volume on early postcibal gastroesophageal reflux in infants. J Pediatr Gastroenterol Nutr 7:185–188PubMed

26.

Tolia V, Lin CH, Kuhns LR (1992) Gastric emptying using three different formulas in infants with gastroesophageal reflux. J Pediatr Gastroenterol Nutr 15:297–301PubMed

27.

Billeaud C, Guillet J, Sandler B (1990) Gastric emptying in infants with or without gastroesophageal reflux according to the type of milk. Eur J Clin Nutr 44:577–583PubMed

28.

Ewer AK, Durbin GM, Morgan ME, et al (1994) Gastric emptying in preterm infants. Arch Dis Child Fetal Neonatal Ed 71: F24–27PubMed

29.

Calbet JA, McLean DA (1977) Role of caloric content on gastric emptying in humans. J Physiol 498:553–559

30.

Sutphen JL, Dillard VL (1989) Dietary caloric density and osmolality influence gastroesophageal reflux in infants. Gastroenterology 97:785–790

31.

Siegal M, Krantz B, Lebenthal E (1985) Effect of fat and carbohydrate composition on the gastric emptying of isocaloric feedings in premature infants. Gastroenterology 89:785–790PubMed

32.

Daniel H, Vohwinkel M, Rehner G (1990) Effect of casein and B-casomorphins on gastrointestinal motility in rats. J Nutr 120:252–257PubMed

33.

Sturner RA, Chang KJ (1991) Opioid peptide content of predigested infant formulas. Pediatr Res 29:A670

34.

Nakai S, Li-an E (1987) Effect of clotting in stomachs of infants on protein digestibility of milk. Food Microstructure 6:161–170

35.

Sidery MB, Macdonald IA, Blackshaw PE (1994) Superior mesenteric artery blood flow and gastric emptying in humans and the differential effects of high fat and high carbohydrate meals. Gut 35:186–190PubMed

36.

Salvia G, De Vizia B, Manguso F, et al (2001) Effect of intragastric volume and osmolality on mechanisms of gastroesophageal reflux in children with gastroesophageal reflux disease. Am J Gastroenterol 96:1725–1732CrossRefPubMed

37.

Euler AR, Ament ME (1977) Detection of gastroesophageal reflux in the pediatric age patient by esophageal intraluminal pH probe measurement (Tuttle test). Pediatrics 60:65–68PubMed

38.

Cavell B (1981) Gastric emptying in infants fed human milk or infant formula. Acta Paediatr Scand 70:639–641PubMed

39.

Benini L, Brighenti F, Castellani G, et al (1994) Gastric emptying of solids is markedly delayed when meals are fried. Dig Dis Sci 39:2288–2294PubMed

40.

McClure RJ, Newell SJ (1996) Effect of fortifying breast milk on gastric emptying. Arch Dis Child Fetal Neonatal Ed 74:F60–62PubMed

41.

Aktas A, Ciftci I, Canner B (1999) The relation between the degree of gastro-esophageal reflux and the rate of gastric emptying. Nucl Med Commun 20:907–910PubMed

42.

Orenstein S (1993) Esophageal disorders in infants and children. Curr Opin Pediatr 5:580–589PubMed

43.

Tolia V, Kuhns L, Kauffrnan R (1993) Correlation of gastric emptying at one and two hours following formula feeding. Pediatr Radiol 23:26–28PubMed

44.

Gelfand MJ, Wagner GG (1991) Gastric emptying in infants and children: limited utility of 1-hour measurement. Radiology 178:379–381PubMed

45.

Ewer AK, Durbin GM, Morgan ME, et al (1996) Gastric emptying and gastro-esophageal reflux in preterm infants . Arch Dis Child Fetal Neonatal Ed 75:F117–121PubMed

46.

Estevao-costa J, Campos M, Dias JA, et al (2001) Delayed gastric emptying and gastroesophageal reflux: a pathophysiological relationship. J Pediatr Gastroenterol Nutr 32:471–474CrossRefPubMed

47.

Pellegrini CA (2001) Delayed gastric emptying in patients with abnormal gastroesophageal reflux. Ann Surg 234:147–148CrossRefPubMed

Title: Ultrasonography and gastric emptying in children: validation of a sonographic method and determination of physiological and pathological patterns
Authors: Hélène Gomes
Patricia Hornoy
Jean Claude Liehn
Publication date: 01-08-2003
Publisher: Springer-Verlag
Published in: Pediatric Radiology / Issue 8/2003
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-003-0954-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ultrasonography and gastric emptying in children: validation of a sonographic method and determination of physiological and pathological patterns

Abstract

Background

Objective

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2003

Fetal dacryocystocele: comparing 2D and 3D imaging

Lassoed liver

Atypical meningioma and extensive calvarium defects in neurofibromatosis type 1

Diffusion-weighted MRI in shaken baby syndrome

Heterotopic gastric mucosa in the gallbladder

Multicentric Castleman's disease in a child with subpectoral involvement