杉山 直史

Tadashi SUGIYAMA

濁協医科大学越谷病院小児外科

Dept. of Pediatvic Surgery, Koshigaya Hospital Dokkyo Univ. School of Medicine

キーワード : Gastroesophageal Reflux, GER, Ultrasound Examination

Ultrasonographic (USG) findings of the lower esophagus, esophago-cardiac junction and gastric fundus were analyzed in 40 infants and small children with Gastroesophageal reflux (GER) and in 20 subjects without GER to the establish criteria for diagnosing GER. The following three specific USG findings are characteristic in patients with GER: (1) The abdominal esophagus in less than 18 mm long. (2) The gastroesophageal angle (GE-angle) is greater than 80 degrees. (3) The frequency of esophageal reflux observed 10 minutes after oral feeding is more than four times. USG findings of at least two of the above-mentioned conditions indicate GER. The sensitivity of diagnosis is 92.5 percent through USG findings compared with 90 percent through pH monitoring and 65 percent through fluoroscopic examination. The rate of false negative (GER could not be diagnosed in infants with GER) is lowest through USG, 7.5 percent, compared with 10 percent through pH monitoring and 35 percent through fluoroscopic examination. These results indicate that USG findings can be obtained easily and repeatedly, without causing a patient any inconvenience. It is the most useful examination for diagnosing GER in infants and small children.