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Eur J Pediatr Surg 2016; 26(02): 172-179
DOI: 10.1055/s-0034-1544049
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Added Value of pH Multichannel Intraluminal Impedance in Adults Operated for Esophageal Atresia

Vladimir Gatzinsky
1   Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Gothenburg, Sweden
,
Olof Andersson
2   Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
,
Anders Eriksson
3   Division of Gastroenterology, Department of Internal Medicine and Geriatrics, SU/Östra, Gothenburg, Sweden
,
Linus Jönsson
1   Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Gothenburg, Sweden
,
Kate Abrahamsson
1   Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Gothenburg, Sweden
,
Ulla Sillén
1   Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Gothenburg, Sweden
› Author Affiliations
Further Information

Publication History

31 July 2014

11 November 2014

Publication Date:
02 February 2015 (online)

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Abstract

Background Gastroesophageal reflux (GER) and dysphagia are common following repaired esophageal atresia (EA). The risk of esophagitis and Barrett esophagus is increased compared with the general population. As yet, the causes are not fully explained.

Purpose The aim of this study was to investigate how GER, measured by pH multichannel intraluminal impedance (pH-MII), is correlated to the esophageal symptoms and histological findings.

Methods Twenty-nine adult subjects operated for EA in Gothenburg from 1968 to 1983 were evaluated with pH-MII, manometry, and gastroscopy.

Results pH-MII was performed in 15, manometry in 19, and gastroscopy in 24 subjects. Eleven subjects displayed pathological reflux parameters of any kind, mainly nonacid reflux (10/15). Dysphagia correlated to the number of weakly acidic reflux episodes. Lower esophageal sphincter (LES) incompetence, which correlated to a pathological number of acid reflux episodes (p = 0.012), was noted in 21/24 subjects, but the majority had a normal resting pressure. Esophagitis was present in 14/24, two of whom had Barrett esophagus. Histological changes correlated to the reflux index and the number of weakly acidic reflux episodes (p = 0.028 and 0.040) and tended to correlate to dysphagia (p = 0.052).

Conclusion pH-MII adds further information when it comes to explaining what causes symptoms and esophageal histological changes in adults operated for EA.

Keywords

esophageal atresia - pH multichannel intraluminal impedance - gastroesophageal reflux - dysphagia - esophagitis
 

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