Revista chilena de radiología
versión On-line ISSN 0717-9308
GARCIA B, Cristián et al. USO Y ABUSO DEL ESTUDIO RADIOLOGICO DE ESOFAGO, ESTOMAGO Y DUODENO EN PACIENTES PEDIATRICOS: NECESIDAD DE UNA ADECUADA NORMATIVA Y DE UNA ESTANDARIZACION DEL EXAMEN . Rev. chil. radiol. [online]. 2005, vol.11, n.1, pp. 23-29. ISSN 0717-9308. doi: 10.4067/S0717-93082005000100006.
Introduction: The role of the upper gastrointestinal radiography study (UGIR) in the evaluation of children with vomiting, has not been well defined in our country, specially regarding its role in the diagnosis of gastroesophageal reflux (GER). GER is in most cases a physiologic condition, manifested by vomiting and/or regurgitation in infants. The American Academy of Pediatrics has insisted on this point, considering the UGIR as a useful study in order to rule out an anatomical cause of vomiting, but in most cases, the clinical history and physical examination are enough to make the diagnosis. Radiologists are performing examinations, in most cases unnecessary and the results are not interpreted appropriately. In a great number of patients, the UGIR is done in order to obtain a maternal license, based on our current law. Patients and Methods: A total of 190 children in whom an UGIR was performed in our Hospital, were included in a prospective study, from April 1, to September 30, 2004. In every case, many parameters were consigned, including clinical history, the reason for the study, etc. Results: This study revealed that most children referred for UGIR study, were infants with vomiting and/or regurgitation without a real indication for the study. In 46 patients (24%), the mother was already under maternal license and in 39 (85%) of these patients, the study was asked for because of vomiting and median age was 4 months. In those infants in whom the mothers did not have license (114 mothers), median age was 3 months. Thirty (26%) of these 114 mothers came to our Hospital in order to obtain a medical license based on the results of the UGIR study. GER was doccumented in 81 patients and 3 had a swallowing disorder. In none of them, an anatomical condition was detected, as the cause of vomiting. Conclusions: Our results confirm that the use of UGIR in children is totally confusing and misunderstood in our country, and in most cases it has been used in order to obtain a medical license for the mothers. We propose either changing the current law in order to extend the maternal license for all the mothers or try to find another diagnostic method. We also propose a standard protocol for the UGIR examination
Palabras clave : Gastroesophageal reflux; Upper gastrointestinal radiography.