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Esposito F, Antonini AE, Brusciano V, Paludi A, Ferrara D, Cardamone A, Zeccolini R, Zeccolini M. Para-oesophageal hernia in 4-month-old girl: possible role of ultrasound-case report and literature review. J Ultrasound 2023; 26:945-950. [PMID: 36445683 PMCID: PMC10632251 DOI: 10.1007/s40477-022-00748-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/19/2022] [Indexed: 12/02/2022] Open
Abstract
Hiatal hernia is the passage of digestive tract portions into the posterior mediastinum through a defect in the esophageal diaphragmatic hiatus. By guidelines, the diagnosis uses first-level radiographic investigations such as chest X-ray and contrastographic methods. As of today, use of ultrasonography in the suspicion/diagnosis of hiatal hernia is not standardized although it shows advantages such as not using ionizing radiation, which is essential in the small pediatric patient. We report the case of a little 4-month-old patient who came to our attention for dysphagia, vomiting and borborygmus to whom Type II hiatal hernia was suspected by ultrasound investigation, later confirmed by guidelines approved methods.
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Affiliation(s)
- Francesco Esposito
- UOSD Diagnostic Radiology Imaging of the Emergency Department, AORN Santobono Pausilipon: Azienda Ospedaliera di Rilievo Nazionale Santobono Pausilipon, Via Mario Fiore, 6, 80129, Naples, Italy
| | - Andrea Ennio Antonini
- Federico II University Hospital: Azienda Ospedaliera Universitaria Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Valentina Brusciano
- Federico II University Hospital: Azienda Ospedaliera Universitaria Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Adriana Paludi
- Federico II University Hospital: Azienda Ospedaliera Universitaria Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Dolores Ferrara
- AORN Santobono Pausilipon: Azienda Ospedaliera di Rilievo Nazionale Santobono Pausilipon, Via Mario Fiore, 6, 80129, Naples, Italy
| | - Annachiara Cardamone
- Federico II University Hospital: Azienda Ospedaliera Universitaria Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Raffaele Zeccolini
- University of Campania Luigi Vanvitelli: Universita degli Studi della Campania Luigi Vanvitelli, Viale Abramo Lincoln, 5, 81100, Caserta, Italy
| | - Massimo Zeccolini
- UOC Diagnostic Radiology Imaging AORN Santobono Pausilipon: Azienda Ospedaliera di Rilievo Nazionale Santobono Pausilipon, Via Mario Fiore, 6, 80129, Naples, Italy
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Piotto L, Gent R. Ultrasound evaluation of the stomach and pylorus in the neonate and baby. SONOGRAPHY 2023. [DOI: 10.1002/sono.12345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Lino Piotto
- Department of Medical Imaging Women's and Children's Hospital North Adelaide South Australia Australia
| | - Roger Gent
- Department of Medical Imaging Women's and Children's Hospital North Adelaide South Australia Australia
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Ma L, Zhu Q, Zhang Y, Li J, Jiang Y, Xu D, Zeng X, Hou Y, Liu H. Esophagus involvement in systemic sclerosis: ultrasound parameters and association with clinical manifestations. Arthritis Res Ther 2021; 23:122. [PMID: 33882993 PMCID: PMC8059267 DOI: 10.1186/s13075-021-02505-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background The esophagus involvement in systemic sclerosis (SSc) is very common yet underestimated due to the lack of suitable screening tools. This study aims to explore the usefulness of ultrasound (US) in the assessment of esophagus involvement and to identify its relationship with clinical and CT manifestations. Methods We performed transabdominal esophageal US in 38 SSc patients and 38 controls. US parameters including the abdominal esophagus length, esophagus wall thickness, shear-wave elastography, gastro-esophageal (His) angle, and reflux were compared. Relationships between distinguishable US parameters and clinical/CT parameters, such as gastro-esophageal reflux disease questionnaire (GERDQ), modified Rodnan skin score (mRSS), interstitial lung disease (ILD) score, the largest esophagus diameter (Dmax), and esophagus dilation percentage (%Eop), were evaluated. Results Abdominal esophagus length was shorter in the SSc group than the control group (2.69 cm vs 3.06 cm, P = 0.018), whereas His angle and the angle change before and after drinking water were larger in the SSc group than the control group (121° vs 108°, P < 0.001; 7.97° vs 2.92°, P = 0.025). Reflux was more frequently seen in the SSc group than the control group (7/38 vs 0/38; P = 0.017). As for correlation with clinical and CT parameters, His angle was higher in patients with GERDQ ≥ 8 than GERDQ < 8 (116.5° vs 125.6°, P = 0.035). Patients with reflux showed higher ILD score than patients without (15.8 vs 9.6, P = 0.043). Furthermore, abdominal esophagus length was negatively correlated with %Eop and Dmax (r = − 0.573, P < 0.001; r = − 0.476, P = 0.003). Conclusion US parameters of the esophagus can distinguish SSc patients from controls, as well as have correlations with clinical and CT characteristics. Our pilot study first shows that US can be used as a noninvasive and convenient method to evaluate the esophagus involvement in SSc.
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Affiliation(s)
- Li Ma
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China
| | - Qingli Zhu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China
| | - Yan Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China
| | - Jianchu Li
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China
| | - Yuxin Jiang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China
| | - Dong Xu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China
| | - Yong Hou
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
| | - He Liu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
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Savino A, Cecamore C, Matronola MF, Verrotti A, Mohn A, Chiarelli F, Pelliccia P. US in the diagnosis of gastroesophageal reflux in children. Pediatr Radiol 2012; 42:515-24. [PMID: 22402830 DOI: 10.1007/s00247-012-2344-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 08/22/2011] [Accepted: 09/17/2011] [Indexed: 12/13/2022]
Abstract
Several techniques have been used to diagnose gastroesophageal reflux (GER) in children, but no single test is sufficiently accurate to completely investigate the problem. Gastroesophageal US has been described as a widely available, noninvasive and sensitive method. It provides morphological and functional information, but its role in the diagnosis of GER in children is still debated. In this paper we review diagnostic approaches to GER in children. We focus on current use of US in the management of children with suspected GER. Reports suggest that US allows exclusion of several non-GER causes of symptoms and that it provides morphological and functional data with high sensitivity and positive predictive value for the diagnosis of GER. Sonographic assessment of findings such as abdominal esophageal length, esophageal diameter, esophageal wall thickness and gastroesophageal angle provide important diagnostic indicators of reflux and related to the degree of GER. There is a need for standardization of the procedure and for defining diagnostic criteria.
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Affiliation(s)
- Alessandra Savino
- Department of Pediatrics, University of Chieti, Via dei Vestini 5, 66013, Chieti, Italy.
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