Abstract
Introduction We aim to assess gastroesophageal reflux (GER) in patients treated for congenital
diaphragmatic hernia (CDH) and to determine whether a pH-metry investigation should
be routinely performed in follow-up.
Materials and Methods Twenty-four-hour pH-metry at 1 year was performed in all patients treated for CDH
between January 2014 and April 2015 (Group 1). We compared pH-metry results to those
of two other groups: children treated for esophageal atresia (EA) (Group 2) and normal
babies presenting with typical symptoms (Group 3). All the pH-metric findings were
analyzed and compared. Intra-group analysis was performed in Group 1.
Results Group 1 consisted of 21, Group 2 of 24, and Group 3 of 21 patients. Mean pH-metry
values for Groups 1, 2, and 3 were, respectively: reflux index (RI) 4.3, 5.1, and
3.9; total number of refluxes (NR) 79.5, 88.8, and 88.7; refluxes longer than 5′ (R > 5) 1.7, 2.3, and 1.47; and longest reflux episode (LR) 11.4, 13.3, and 8.6. No
significant differences were found between Group 1 and the others. Only two CDH patients
presented with GER-related symptoms. Patch was associated with significantly higher
RI (8.5 vs. 2.98, p = 0.03). The worse was the defect, the worse were the pH-metric results (RI: A3.09,
B3.15, and C9.1).
Conclusion We believe that a routine GER assessment should be performed in all CDH patients
regardless the presence of symptoms.
Level of Evidence This is a Level II study.
Keywords
congenital diaphragmatic hernia - gastroesophageal reflux - pH-metry - esophageal
atresia - follow-up
