Eur J Pediatr Surg
DOI: 10.1055/s-0038-1675776
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Esophageal Diameters in Children Correlated to Body Weight

Thomas Sebastian Bott*
1  Department of Pediatric Surgery, Olga Hospital, Klinikum Stuttgart, Stuttgart, Germany
,
Thekla von Kalle*
2  Department of Pediatric Radiology, Olga Hospital, Klinikum Stuttgart, Stuttgart, Germany
,
Alexander Schilling
2  Department of Pediatric Radiology, Olga Hospital, Klinikum Stuttgart, Stuttgart, Germany
,
Oliver Heinz Diez
1  Department of Pediatric Surgery, Olga Hospital, Klinikum Stuttgart, Stuttgart, Germany
,
Sarah Besch
3  Department of Neonatology, University Children's Hospital Tübingen, Tübingen, Germany
,
Ulrike Mehlig
1  Department of Pediatric Surgery, Olga Hospital, Klinikum Stuttgart, Stuttgart, Germany
,
Svetlana Hetjens
4  Department of Medical Statistics and Biomathematics, Medical Faculty of Mannheim, Mannheim, Germany
,
Lucas Wessel
5  Department of Pediatric Surgery, University Hospital of Mannheim, Mannheim, Germany
,
Steffan Loff
1  Department of Pediatric Surgery, Olga Hospital, Klinikum Stuttgart, Stuttgart, Germany
› Author Affiliations
Further Information

Publication History

19 June 2018

06 October 2018

Publication Date:
26 November 2018 (eFirst)

Abstract

Introduction The development of stenoses after correction of an esophageal atresia or acid and lye burn of the esophagus are well-known problems in pediatric surgery. Currently, stenoses are treated in the majority of cases by repeated balloon dilatations. The diameter of the balloons used is not standardized; standard curves do not exist. The aim of this study was to evaluate the diameter of the esophagus correlated to the body weight of the children as measured in upper gastrointestinal (GI) studies to answer the important question to what extent a stenosis should be dilated.

Patients Within the time period from 2011 through 2016, 60 patients with upper GI studies were selected. Evaluations were blinded to two different examiners. The diameters were measured under maximum contrast filling between the second and third rib (cranial point of measurement) and between the seventh and eighth rib (caudal point of measurement). For both, the anteroposterior and lateral aspect was examined. The diameter was calculated as the arithmetic average of both measurements within one level. The diameters were correlated to the weight of the children.

Results All children (n = 38) within the 3rd to 97th weight percentile were analyzed. Linear correlation and coefficients of 0.67 at the cranial point and 0.70 at the caudal point were found. Mean diameter at the cranial point of measurement was 6.75 mm at the lowest weight (2.6 kg) and 14 mm at 74 kg. Mean weight of these children (standard deviation [SD]) was 25.3 (18.8) kg and median age was 7 years. Within weight groups (0–10 kg; 10–20 kg; 20–35 kg; 35–50 kg; >50 kg), we calculated SD and two side tested critical 95% confidence interval for all measurements (n = 74).

Conclusion Although the variation in measurements is considerable, this evaluation gives a reliable hint to which extent esophageal stenoses should be dilated in relation to the body weight. To the best of our knowledge, this is the first investigation to evaluate the diameter of the esophagus in children in relation to the body weight.

* These authors contributed equally to this work.