PMID- 32639450
OWN - NLM
STAT- MEDLINE
DCOM- 20210618
LR  - 20210618
IS  - 1536-4801 (Electronic)
IS  - 0277-2116 (Linking)
VI  - 71
IP  - 4
DP  - 2020 Oct
TI  - Implementation of a Timed Barium Esophagram Protocol for Assessment of Esophageal 
      Function in Children.
PG  - 470-475
LID - 10.1097/MPG.0000000000002829 [doi]
AB  - OBJECTIVES: Timed barium esophagram (TBE) is a fluoroscopic study that is widely 
      employed as an adjunctive tool for diagnosing esophageal emptying disorders in 
      adults (eg, achalasia, esophagogastric junction outflow obstruction [EGJOO]) and 
      for following response to treatment. We aimed to describe the characteristics and 
      feasibility of a pediatric TBE protocol and provide a first report of the 
      potential value of TBE for assessment of esophageal emptying in the pediatric 
      population. METHODS: Retrospective chart review of pediatric patients at a 
      tertiary pediatric hospital who underwent TBE from October 2017 to October 2019. 
      Patient and test characteristics were summarized using descriptive statistics. 
      Results from patients who had both TBE and high-resolution esophageal manometry 
      (HRM) were used to generate ROC curves for TBE to identify esophageal emptying 
      disorders. RESULTS: Twenty-two patients underwent 25 TBE. Fourteen of 23 (61%) 
      received 150 mL barium volume per protocol. Nearly half (42%) of subjects could 
      tolerate ingesting barium within 20 seconds. Nine individuals underwent HRM. The 
      sensitivity of standard adult TBE criteria (1 cm barium column height at 
      5 minutes) to detect emptying disorder was 100%, specificity 40%. A modified 
      diagnostic cutoff (1.6 cm height at 5 minutes) offered 100% sensitivity, 80% 
      specificity. CONCLUSIONS: TBE is feasible and should be considered an adjunctive 
      noninvasive screen for impaired esophageal emptying in children. There was 
      heterogeneous adherence to protocol for timing and volume of barium; however, 
      studies remained interpretable. This population may benefit from different 
      diagnostic cutoffs than adults, and clinical judgment should be used until 
      specific diagnostic cutoffs are determined in children.
FAU - Rosenwald, Kent D
AU  - Rosenwald KD
AD  - Digestive Health Institute, Children's Hospital Colorado.
AD  - University of Colorado School of Medicine.
FAU - Hayes, Kari
AU  - Hayes K
AD  - University of Colorado School of Medicine.
AD  - Department of Radiology, Children's Hospital Colorado, Aurora, CO.
FAU - Menard-Katcher, Calies
AU  - Menard-Katcher C
AD  - Digestive Health Institute, Children's Hospital Colorado.
AD  - University of Colorado School of Medicine.
FAU - Belkind-Gerson, Jaime
AU  - Belkind-Gerson J
AD  - Digestive Health Institute, Children's Hospital Colorado.
AD  - University of Colorado School of Medicine.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Pediatr Gastroenterol Nutr
JT  - Journal of pediatric gastroenterology and nutrition
JID - 8211545
RN  - 24GP945V5T (Barium)
RN  - 25BB7EKE2E (Barium Sulfate)
SB  - IM
MH  - Adult
MH  - Barium
MH  - Barium Sulfate
MH  - Child
MH  - *Esophageal Achalasia
MH  - Humans
MH  - Manometry
MH  - Retrospective Studies
EDAT- 2020/07/09 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/07/09 06:00
PHST- 2020/07/09 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/07/09 06:00 [entrez]
AID - 00005176-202010000-00011 [pii]
AID - 10.1097/MPG.0000000000002829 [doi]
PST - ppublish
SO  - J Pediatr Gastroenterol Nutr. 2020 Oct;71(4):470-475. doi: 
      10.1097/MPG.0000000000002829.