Document Detail


Radionuclide scintigraphy in the evaluation of gastroesophageal reflux in symptomatic and asymptomatic pre-term infants.
MedLine Citation:
PMID:  18483812     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Gastroesophageal reflux (GER) is very common in pre-term infants. The diagnosis based on symptoms is always questionable. The incidence of GER in symptomatic babies varies from 22% to 85%, but literature regarding the incidence of reflux in asymptomatic pre-term infants is lacking. We used radionuclide scintigraphy to evaluate the incidence of GER in symptomatic as well as asymptomatic pre-term neonates and to assess whether symptoms have any relation with positive scintigraphy. METHODS: We studied 106 pre-term infants (52 symptomatic, 54 asymptomatic) of less than 34 weeks of gestation, who fulfilled the eligibility criteria. Babies were considered symptomatic in the presence of vomiting, regurgitation, apnea, de-saturations, unexplained bradycardia and recurrent lung collapses. Radionuclide scintigraphy was conducted at post-conceptional age of 32-34 weeks when they were clinically stable for 72 h. Feeding was avoided for 2 h preceding the study. (99m)Tc sulphur colloid was administered in a dose of 1.85 MBq (0.05 mCi) in 1 ml, followed by milk (full feed) through an orogastric tube, prior to imaging under a gamma camera. Reflux was graded as low or high, and reflux episodes during the study were counted. RESULTS: The incidence of GER in the symptomatic group was 71.2% and in asymptomatic babies 61.1% (p = 0.275). High-grade reflux was more common (71.4%) than low-grade (28.6%) in both groups (p = 0.449). Mean number of reflux episodes in 20 min was 4.4 +/- 2.4 in symptomatic babies and 4.9 +/- 2.2 in asymptomatic babies (p = 0.321). Babies with positive scintigraphy were similar in birth weight, gestation, time to achieve full feeds, weight and age at discharge to those with negative scintigraphy. CONCLUSIONS: GER is common in pre-term infants of less than 34 weeks gestation. The incidence of positive scintigraphy and grade of reflux is not significantly different in symptomatic vs. asymptomatic babies. Though radionuclide scintigraphy is a simple, quick and non-invasive investigation in suspected cases of GER, positive scintigraphy has no correlation with symptoms.
Authors:
C Morigeri; A Bhattacharya; K Mukhopadhyay; A Narang; B R Mittal
Publication Detail:
Type:  Journal Article     Date:  2008-05-16
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  35     ISSN:  1619-7070     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-22     Completed Date:  2008-12-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1659-65     Citation Subset:  IM    
Affiliation:
Division of Neonatology, Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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MeSH Terms
Descriptor/Qualifier:
Female
Gastroesophageal Reflux / pathology*,  radionuclide imaging*
Humans
Infant, Newborn
Infant, Premature*
Male
Pregnancy

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