760 Radionuclide Gastroesophageal Reflux Scan; An Effective Screening Tool for Infants/Children with Repeated Chest Infections

Abstract

Objective: Unexplained recurrent chest infections are a cause of failure to thrive in infants and young children. Repeated hospital admissions with respiratory symptoms are an extra economic burden on the health budget along with the morbidity. Aim of this study was twofold; first to analyze the utility of Nuclear Medicine to screen children with clinically significant gastroesophageal reflux and secondly to evaluate the lesion after conventional treatment.

Place of study: Punjab Institute of Nuclear Medicine in collaboration with department of pediatrics, Allied Hospital Faisalabad.

Patients and Methods: Seventy clinically symptomatic patients underwent Gastroesophageal Reflux (GER) Scan with effective fasting of 1-3hrs. 20-37MBq of ^99m Tc labeled Colloid was diluted in milk for oral intake. 30min dynamic study with 3 second per frame was acquired. Both qualitative and quantitative analysis was done using cine review, time active curves (TAC) and percentage reflux index (%RI). Patients with high grades of reflux were reviewed again after 08 weeks of conventional antireflux treatment.

Results: 63% of the patients (44/70) were reflux positive, of which (26/44) were in grade I/II category while (13/44) showed moderate degree reflux and only (2/44) showed severe reflux. Chest infection was the chief clinical presentation in each case (57%). Eighty percent of selected patients (8/10) showed improvement with conventional antireflux treatment.

Conclusion: GER scan is a non-invasive, effective way of screening clinically symptomatic babies for reflux of gastric contents. Quantitative assessment of improvement after conventional antireflux treatment offers cost-effective follow-up of GERD.

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