Is the Diagnosis of Gastroptosis Still Useful in Clinical or Radiographic Settings?
Keywords:
Gastroptosis, Delayed gastric emptying, Impaired gastric motilityAbstract
Introduction: Gastroptosis was a frequent diagnosis in former days, however in current practice it is a rare diagnosis with uncertain etiology, with only a few number of studies to support it. Gastroptosis is diagnosed on a nupper gastrointestinal (GI) study by the downward displacement of the greater curve of the stomach below the level of the iliac crests in a standing position. Gastroptosis could possibly cause GI symptoms and delayed gastric emptying, but the relation is unknown, especially in children. This study addresses the association of GI symptoms and gastroptosis in children in the Netherlands.
Methods: We present a retrospective study of all children aged 6 to 18 years who underwent an upper GI study of the stomach in a 5-year period in our university children’s hospital. Sixty of one hundred sixty-one children were included in the analysis, of whom seven appeared to have a radiological diagnosis of gastroptosis.
Results: GI symptoms were not significantly different between children with and without gastroptosis. Compared to the control group, there was a significant higher incidence of decreased gastric motility (p=0.004) in children with gastroptosis, as well as delayed gastric emptying (p=0.045).
Conclusion: Children with gastroptosis did not have specific GI symptoms. Gastroptosis was associated with decreased gastric motility and delayed gastric emptying, which could either be the cause of the gastroptosis or a consequence. The radiologic diagnosis gastroptosis had no consequence regarding treatment. Therefore, gastroptosis on an upper GI study seems clinically irrelevant.
References
Christianakis E, Bouchra K, Koliatou A, Paschalidis N, Filip-pou D. Gastroparesis associated with gastroptosis presenting as a lower abdominal bulking mass in a child: A case report. Cases J. 2009; 2: 184. doi: 10.1186/1757-1626-2-184
Kusano M, Moki F, Hosaka H, et al. Gastroptosis is associated with less dyspepsia, rather than a cause of dyspepsia, in Japanese persons. Intern Med. 2011; 50(7): 667-671. doi: 10.2169/inter-nalmedicine.50.4582
Natsis K, Apostolidis S, Papadopoulou AL, et al. Gastric femoral hernia in a male cadaver with gastroptosis: Case report and review of the literature. Hernia. 2008; 12(2): 205-208. doi: 10.1007/s10029-007-0272-x
Eve F. The surgical treatment of gastroptosis: Being an analy-sis of a series of twenty cases, wi special reference to the results of operative treatment. Br Med J. 1910; 1(2575): 1098-1101.
Perez ME, Youssef NN. Dyspepsia in childhood and adoles-cence: Insights and treatment considerations. Curr Gastroenter-ol Rep. 2007; 9(6): 447-455. doi: 10.1007/s11894-007-0058-4
Rasquin A, Di Lorenzo C, Forbes D, et al. Childhood func-tional GI disorders: Child/adolescent. Gastroenterology. 2006; 130(5): 1527-1537. doi: 10.1053/j.gastro.2005.08.063
Devanarayana NM, Rajindrajith S, Perera MS, Nishanthanie SW, Benninga MA. Gastric emptying and antral motility param-eters in children with functional dyspepsia: Association with symptom severity. J Gastroenterol Hepatol. 2013; 28(7): 1161- 1166. doi: 10.1111/jgh.12205
Hoffman I, Tack J. Assessment of gastric motor function in childhood functional dyspepsia and obesity. Neurogastroen-terol Motil. 2012; 24(2): 108-112, e181. doi: 10.1111/j.1365- 2982.2011.01813.x
Kindt S, Tack J. Impaired gastric accommodation and its role in dyspepsia. Gut. 2006; 55(12): 1685-1691. doi: 10.1136/ gut.2005.085365
Barbat JH. Surgical treatment of gastroptosis. Cal State J Med. 1907; 5(10): 254-257.
Hall-Edwards JF. The diagnosis and treatment of gastropto-sis. Br Med J. 1921;1(3150):698-700.
Barneveld PC, van Urk P. Aanbevelingen nucleaire ge-neeskunde. 2007. Web site. http://www.nvng.nl/nvng/uploads/ aanbevelingen/aanbevelingenhtml/Aanbevelingen%20deel%20 I%20en%20II.html. Accessed February 20, 2015.
George NS, Sankineni A, Parkman HP. Small intestinal bac-terial overgrowth in gastroparesis. Dig Dis Sci. 2014; 59(3): 645-652. doi: 10.1007/s10620-012-2426-7
Reddymasu SC, McCallum RW. Small intestinal bacte-rial overgrowth in gastroparesis: Are there any predictors? J Clin Gastroenterol. 2010; 44(1): e8-e13. doi: 10.1097/ MCG.0b013e3181aec746
Venkatasubramani N, Sood MR. Motility disorders of the GI tract. Indian J Pediatr. 2006; 73(10): 927-930. doi: 10.1007/ BF02859288
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