Barrett's esophagus in childhood.
Barrett's esophagus in childhood.
复制标题
童年时的巴雷特食管。
DOI：
10.1016/0016-5085(85)90651-1
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发表时间：
1985
期刊：
影响因子：
29.4
通讯作者：
Ament,ME
中科院分区：
文献类型：
--
作者：
Hassall,E;Weinstein,WM;Ament,ME
本研究描述了11例6-14岁儿童Barrett食管的临床、放射学、食管功能检查、内镜和组织学表现。所有人都有胃食管反流的长期症状，11人中有10人在出生后的第一年就开始了。11名患者中有8名患有食管中段或上段狭窄，11名患者中有10名需要胃底折叠术。大多数患者食管下括约肌压力低，pH探头检查异常。在11名儿童中，只有6名在内窥镜检查时有特征性的粉红色粘膜外观。在食管多个层面采集的50份内镜活检标本在胃食管交界处上方含有柱状内衬上皮。其中5例患者的组织学谱中有特化（膀胱型）上皮。儿童Barrett食管的临床表现与成人相似，只是狭窄似乎在儿童中更常见，并且粘膜的内镜外观并不总是典型的颜色。在成人中，胃食管反流似乎是病因。在婴儿期以上的儿童中，巴雷特食管是我们机构抗反流手术的最常见适应症。活检标本应取自食管的多个层面，以避免过度诊断，并确定诊断。
This study describes the clinical, radiologic, esophageal function test, endoscopic, and histologic findings of Barrett's esophagus in 11 children aged 6–14 yr. All had long-standing symptoms of gastroesophageal reflux, which had begun in the first year of life in 10 of the 11. Eight of the 11 patients had mid or upper esophageal strictures and 10 of the 11 required fundoplication. Most patients had low lower esophageal sphincter pressures and abnormal pH probe studies. Only 6 of the 11 children had the characteristic pink-red appearance of the mucosa at endoscopy. Fifty endoscopic biopsy specimens taken at multiple levels in the esophagus contained columnar-lined epithelium above the gastroesophageal junction. Five of the patients had specialized (intestinal-type) epithelium as part of the histologic spectrum. The clinical expression of Barrett's esophagus in children is similar to that in adults except that strictures appear to be more common in children, and the endoscopic appearance of the mucosa is not always typical in color. As in adults, gastroesophageal reflux appears to be the etiology. In children beyond infancy, Barrett's esophagus is the most common indication for antireflux surgery at our institution. Biopsy specimens should be taken from multiple levels in the esophagus to avoid overdiagnosis and to establish the diagnosis with certainty.