Abstract
Of 62 children (1–24 months of age) evaluated for esophageal disease, 22 were found to have pulmonary symptoms of apnea, pneumonia, wheezing, cyanosis, cough and stridor. Upper gastrointestinal series showed free gastroesophageal reflux in 10 of 22 infants; 3 were thought to have stricture. Acid-reflux test was positive in 13 of 15 and correlated with the presence of esophagitis in 12. In addition to esophagitis, endoscopic examination found two foreign bodies and an esophageal stricture unrecognized during fluoroscopy. Endoscopic grasp biopsy was inadequate in most infants for the histologic evaluation of esophagitis. However, suction biopsy correlated well with endoscopically diagnosed esophagitis. In infants where medical therapy failed and symptoms were life-threatening, a Nissen fundoplication resulted in excellent resolution of symptoms. In children who present with prolonged and often life-threatening symptoms, esophageal dysfunction should be evaluated by rigorous testing.
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