Vol. 24 - Num. 93
aPediatra. CS de Mutxamel. Alicante. España.
bServicio de Pediatría. Hospital General Universitario de Elche. Elche. Alicante. España.
cServicio de Pediatría. Hospital Universitario del Vinalopó. Elche. Alicante. España.
Correspondence: A López. E-mail: firstname.lastname@example.org
Reference of this article: López Yáñez A, Vázquez Gomis R, Murcia Clemente L, Pastor Rosado J. Usefulness of ultrasound as a diagnostic method of pathological acid reflux in comparison with esophageal pH measurement. Rev Pediatr Aten Primaria. 2022;24:e73-e79.
Published in Internet: 03-02-2022 - Visits: 1941
Introduction: the gold standard for diagnosis of acid reflux in pediatrics is 24h pHmetry. Ultrasound has proven to be a bloodless technique and there are few studies that compare it with pHmetry.
Methods: prospective, observational and analytical study. Ultrasound study was performed on patients with an indication of pHmetry, and prior to it. Sonographic variables proposed by the SEGHNP ultrasound group (Gomes 1991 modified) were determined, considering the presence of pathological acid reflux if it had two or more altered parameters.
Results: 32 patients were included, 68.8% (n = 22) men, between 1 month and 13 years. 59.3% had pathological pHmetry (n = 19). The diagnosis of ultrasound reflux as proposed by SEGHNP was not related to the diagnosis of acid reflux by pHmetry (p = 0.169). The ultrasound showed a sensitivity of 60% and a specificity of 61.5%, with a positive predictive value (PPV) of 70.58% and a negative predictive value of 53.3%. When analyzing each ultrasound variable and comparing it with the presence of reflux by pHmetry there were no significant data. However, a pathological Hiss angle and an abdominal esophagus length of less than 1.3 cm were statistically related to acid reflux by pHmetry (p = 0.033), obtaining a PPV, positive probability ratio and positive pretest probability (88.9%, 5.47, 89.1%, respectively), with low false positive rate (7.7%).
Conclusión: in our study population, the ultrasound criteria proposed by the SEGHNP are not related to pathological acid pHmetry, but the presence of an abdominal esophagus smaller than 1.3 cm along with a Hiss angle greater than 110°.
Keywords● Abdominal ultrasound ● Esophageal pH monitoring ● Gastroesophageal reflux disease ● Gastroesophageal reflux disease
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