Eur J Pediatr Surg 2015; 25(04): 326-332
DOI: 10.1055/s-0035-1559818
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Dysphagia in Children with Esophageal Atresia: Current Diagnostic Options

Maissa Rayyan
1  Neonatal Intensive Care Unit, University Hospital Leuven, Leuven, Belgium
,
Karel Allegaert
1  Neonatal Intensive Care Unit, University Hospital Leuven, Leuven, Belgium
,
Taher Omari
2  Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
3  School of Medicine, Flinders University, Adelaide, Australia
,
Nathalie Rommel
2  Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
4  Neurosciences ExpORL, KU Leuven, Leuven, Belgium
› Author Affiliations
Further Information

Publication History

24 June 2015

26 June 2015

Publication Date:
26 August 2015 (online)

Abstract

Dysphagia or swallowing disorder is very common (range, 15–52%) in patients with esophageal atresia. Children present with a wide range of symptoms. The most common diagnostic tools to evaluate esophageal dysphagia, such as upper barium study and manometry, aim to characterize anatomy and function of the esophageal body and the esophagogastric junction (EGJ). Using these technologies, a variety of pathological motor patterns have been identified in children with esophageal atresia. However, the most challenging part of diagnosing patients with esophageal dysphagia lies in the fact that these methods fail to link functional symptoms such as dysphagia with the esophageal motor disorders observed. A recent method, called pressure-flow analysis (PFA), uses simultaneously acquired impedance and manometry measurements, and applies an integrated analysis of these recordings to derive quantitative pressure-flow metrics. These pressure-flow metrics allow detection of the interplay between bolus flow, motor patterns, and symptomatology by combining data on bolus transit and bolus flow resistance. Based on a dichotomous categorization, flow resistance at the EGJ and ineffective esophageal bolus transit can be determined. This method has the potential to guide therapeutic decisions for esophageal dysmotility in pediatric patients with esophageal atresia.