Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark.
J Pediatr Surg. 2013 Dec;48(12):2487-95. doi: 10.1016/j.jpedsurg.2013.07.019.
Esophageal atresia (EA) is one of the most frequent congenital alimentary tract anomalies with a considerable morbidity throughout childhood. This study evaluates the gastroesophageal problems in 5-15 year old children with EA and aims to identify factors predisposing to esophagitis in EA.
Fifty-nine patients primarily operated at Odense University Hospital, Denmark, during 1993-2005 were included in this follow-up study. The patients underwent the following examinations: Interview, upper endoscopy, endoscopic ultrasonography, high-resolution esophageal manometry (HREM), and pH- and multichannel intraluminal impedance (MII) measurements. Twenty-five patients with suspected gastro-esophageal reflux disease (GERD) underwent the same investigations and served as controls.
Median age was 10.2 years (7.1-13.3). Thirty-three (55.9%) presented with GERD symptoms, 41 (69.5%) with dysphagia, and 33 (55.9%) with respiratory symptoms. Twenty-nine (49.2%) had endoscopic esophagitis, and 26 (44.1%) histological esophagitis. Median reflux index (RI) was 8.3 (4.8-14.9). In 32 (55.2%) RI was above 7. Ten percent had eosinophilic inflammation. HREM showed dysmotility in the esophagus in all EA patients, 83.3% had no propagating swallows. No predictive factors predisposing the development of endoscopic esophagitis were identified.
Gastroesophageal problems in children born with EA are common. Routine follow-up with endoscopy and pH-metry in EA patients is warranted.
食管闭锁（EA）是最常见的先天性消化道畸形之一，在儿童时期有相当高的发病率。本研究评估了 5-15 岁 EA 患儿的胃食管问题，并旨在确定导致 EA 食管炎的易患因素。
本随访研究纳入了 1993-2005 年期间在丹麦奥登塞大学医院初次手术的 59 例患者。患者接受了以下检查：访谈、上内窥镜检查、内镜超声检查、高分辨率食管测压（HREM）和 pH 值及多通道腔内阻抗（MII）测量。25 例疑似胃食管反流病（GERD）的患者接受了相同的检查作为对照组。
中位年龄为 10.2 岁（7.1-13.3）。33 例（55.9%）有 GERD 症状，41 例（69.5%）有吞咽困难，33 例（55.9%）有呼吸症状。29 例（49.2%）有内镜食管炎，26 例（44.1%）有组织学食管炎。中位反流指数（RI）为 8.3（4.8-14.9）。32 例（55.2%）RI 高于 7。10%有嗜酸性炎症。HREM 显示所有 EA 患者食管运动障碍，83.3%无传播性吞咽。未发现易患内镜食管炎发展的预测因素。
出生时患有 EA 的儿童存在胃食管问题较为常见。EA 患者常规进行内镜和 pH 监测随访是必要的。
