[Diagnosis of gastroesophageal reflux in childhood. Comparison of ultrasonography and barium swallow].

Gastroesophageal reflux (GER) is a very common event in the pediatric patient. An accurate and atraumatic imaging technique must be used to differentiate normal from abnormal conditions. Sonography (US) appears to answer this purpose, as recently shown in the international literature. One hundred and seventy-eight patients with suspected GER were enrolled in this study; their age ranged 10 days to 15 years. They were examined with both US and barium swallow, in a double-blind trial. The patients were divided into three groups, according to GER severity, i.e., absent or physiologic GER, moderate GER and severe GER. We considered not only the number of reflux episodes, as related to patients' age, but also reflux volume, esophagus clearing time and possibly coexisting hiatal hernia or esophagitis. US and barium swallow results were in agreement in 93% of the cases. In the other cases US demonstrated more severe GER than barium meal. No statistically significant differences were observed in the various age groups. Since US is a relatively cost-effective, noninvasive and physiologic method which is widely available and uses no ionizing radiations, it can be recommended as the screening test of choice in symptomatic children and in the follow-up.