Predictors of histopathological esophagitis in infants and adolescents with esophageal atresia within a national follow-up programme.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2022
2022
Historique:
received:
23
09
2021
accepted:
25
03
2022
entrez:
15
4
2022
pubmed:
16
4
2022
medline:
20
4
2022
Statut:
epublish
Résumé
Esophageal atresia (EA) is a congenital anomaly of the foregut. Although the survival has improved over the years there is a significant gastrointestinal morbidity affecting physical function and health-related quality of life. The aims of the study were to identify and evaluate predictors of histopathological esophagitis in infants and adolescents with EA. Single centre, cross-sectional study including one and 15-year-old patients operated for EA that participated in the national follow-up programme between 2012 and 2020 according to a pre-established protocol including upper endoscopy with oesophageal biopsies and 24h-pH-test. Data was collected from patients' medical records and pH-analysis software. Regression models were used to identify predictors of histopathological oesophagitis. Possible predictors were abnormal reflux index, endoscopic esophagitis, hiatal hernia, symptoms of gastroesophageal reflux (GER) and age. 65 patients were included, 47 children and 18 adolescents. All children were treated with PPI during their first year of life. Symptoms of GER were reported by 13 (31.7%) of the infant's caregivers, 34 of the children (72.3%) had abnormal reflux index and 32 (68.1%) had histopathological esophagitis. The corresponding numbers for adolescents were 8 (50%), 15 (83.3%) and 10 (55.6%). We found no significant associations between histopathological esophagitis and endoscopic esophagitis, symptoms of GER, hiatus hernia or age group. Abnormal reflux index was an independent predictor of histopathological esophagitis. Seven patients with normal reflux index had histopathological esophagitis, all grade I. We found a high prevalence of histopathological esophagitis despite PPI treatment in accordance with recommendations. No significant difference between the two age groups was seen. Abnormal reflux index was an independent predictor of histopathological esophagitis. However, we cannot recommend the use of pH-metry as a substitute for esophageal biopsies; future studies are needed to elucidate if esophageal biopsies might be postponed in infants with normal reflux index.
Identifiants
pubmed: 35427378
doi: 10.1371/journal.pone.0266995
pii: PONE-D-21-30795
pmc: PMC9012387
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0266995Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Pediatr Surg. 1997 Nov;32(11):1580-6
pubmed: 9396530
World J Gastroenterol. 2018 Mar 7;24(9):1056-1062
pubmed: 29531469
Pediatr Surg Int. 2008 May;24(5):531-6
pubmed: 18351365
J Pediatr Surg. 2013 Dec;48(12):2487-95
pubmed: 24314192
J Pediatr Surg. 2005 Feb;40(2):307-12
pubmed: 15750920
Eur J Pediatr Surg. 2011 Mar;21(2):94-8
pubmed: 21283959
Eur J Pediatr Surg. 2013 Aug;23(4):273-5
pubmed: 23172565
Bull World Health Organ. 2007 Sep;85(9):660-7
pubmed: 18026621
Br J Surg. 1996 Sep;83(9):1268-70
pubmed: 8983626
J Pediatr Surg. 2007 Aug;42(8):1433-8
pubmed: 17706510
Pediatr Surg Int. 2011 Nov;27(11):1141-9
pubmed: 21960312
Pediatr Surg Int. 1999;15(1):8-10
pubmed: 9914345
Eur J Pediatr Surg. 2019 Dec;29(6):510-515
pubmed: 30566986
Pediatrics. 2012 Sep;130(3):e476-85
pubmed: 22908104
J Pediatr Surg. 2016 Sep;51(9):1421-5
pubmed: 27114309
Am J Roentgenol Radium Ther Nucl Med. 1961 Nov;86:884-7
pubmed: 14456320
Dig Liver Dis. 2015 Dec;47(12):1027-32
pubmed: 26362613
Pediatr Surg Int. 2012 Mar;28(3):249-57
pubmed: 22020495
BMC Pediatr. 2013 Apr 20;13:59
pubmed: 23601190
J Pediatr Gastroenterol Nutr. 2016 Apr;62(4):562-6
pubmed: 26348684
J Pediatr Gastroenterol Nutr. 2016 Nov;63(5):550-570
pubmed: 27579697
J Pediatr Surg. 1980 Feb;15(1):74-8
pubmed: 7365661
Can J Gastroenterol. 2010 May;24(5):312-6
pubmed: 20485706
Arch Dis Child. 2012 Sep;97(9):808-11
pubmed: 22753768
J Pediatr Surg. 2013 Dec;48(12):2496-505
pubmed: 24314193
Pediatrics. 2011 Nov;128(5):e1053-61
pubmed: 21969289
Am J Surg Pathol. 2007 May;31(5):706-10
pubmed: 17460453
J Pediatr Gastroenterol Nutr. 2019 Aug;69(2):163-170
pubmed: 30921254
J Pediatr Gastroenterol Nutr. 2011 Jun;52(6):686-90
pubmed: 21597403
J Pediatr Gastroenterol Nutr. 2019 Nov;69(5):515-522
pubmed: 31490855
Pediatr Surg Int. 1997;12(8):552-5
pubmed: 9354724
J Neurosurg Anesthesiol. 2009 Oct;21(4):286-91
pubmed: 19955889
J Pediatr Gastroenterol Nutr. 2019 Jul;69(1):45-51
pubmed: 30889131
Acta Paediatr. 2010 Mar;99(3):411-7
pubmed: 19912137
BMC Pediatr. 2014 Feb 03;14:32
pubmed: 24490896
Ann Surg. 2010 Jun;251(6):1167-73
pubmed: 20485152
Anesth Analg. 2011 Nov;113(5):1143-51
pubmed: 21415431
Gastroenterology. 1970 Feb;58(2):163-74
pubmed: 5413015
J Pediatr Surg. 1998 Mar;33(3):476-80
pubmed: 9537560
Anesthesiology. 2009 Apr;110(4):796-804
pubmed: 19293700
J Pediatr Surg. 2003 May;38(5):702-4
pubmed: 12720174
Eur J Pediatr Surg. 2017 Apr;27(2):192-195
pubmed: 27214095
Eur J Pediatr Surg. 2017 Feb;27(1):50-55
pubmed: 27769086
World J Surg. 2007 Jul;31(7):1512-7
pubmed: 17534555
Public Health Nutr. 2006 Oct;9(7):942-7
pubmed: 17010261
Eur J Pediatr Surg. 2020 Dec;30(6):475-482
pubmed: 31777030