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Oral Presentation - 40
Pilot study: The role of Body Surface Gastric Mapping in evaluating gastric function in children with Oesophageal Atresia
S Raza*, G Humphrey**, D Foong***, S Kelly****, S Calder*****, G O'Grady******, V Ho*******, U Krishnan********
*School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
**Department of Surgery, The University of Auckland, Auckland, New Zealand
***School of Medicine, Western Sydney University, Sydney, Australia
****Department of Paediatric Gastroenterology, Sydney Children’s Hospital, Sydney, Australia
*****Alimetry Ltd, Auckland, New Zealand
******Department of Surgery, The University of Auckland, Auckland, New Zealand,
*******School of Medicine, Western Sydney University, Sydney, Australia, Gastroenterology Department, Campbelltown Hospital, Sydney, Australia
********School of Women’s and Children’s Health, University of New South Wales, Sydney, and Department of Paediatric Gastroenterology, Sydney Children’s Hospital, Sydney, Australia
Background. Oesophageal atresia (OA) is a rare congenital gastrointestinal malformation where patients also have impaired vagal function. Despite gastroduodenal symptoms and feeding difficulties, data on gastric dysfunction is limited. Body surface gastric mapping (BSGM), a novel tool for recording gastric myoelectrical activity, was reviewed in six OA patients to explore pathophysiologies.
Methods: BSGM testing involves a 6-hour fast, 4.5-hour recording (30-minute baseline, 482kCal standard meal and 4-hour postprandial), and continuous symptom monitoring. Data collected includes demographics, anthropometrics, OA type, surgeries, medications, recent investigations and questionnaires. Spectral metrics were referenced a priori to normative adult reference intervals.1
Results: Six patients (4 female, median age 13, median BMI 17.1) were recruited. 4 cases had Type C OA and 2 cases had Type A OA, all primary repairs. Meal completion was median 70%. Compared to normative reference intervals, BSGM spectral analysis revealed abnormalities in 5/6 cases: low BMI-adjusted amplitude and/or Gastric Alimetry Rhythm Index (n=2; indicative of gastric neuromuscular dysfunction), delayed gastric activity with transient frequency abnormalities (n=2), and high BMI-adjusted amplitude and high principal gastric frequency (n=1; indicative of possible vagal nerve injury). On the day, symptoms showed mixed profiles: meal-responsive (n=5) and no symptoms (n=1).
Conclusion: BSGM found 5 of 6 OA cases had abnormal gastric activity, either a delay in gastric activity post-meal, neuromuscular abnormality, or vagal nerve injury. Identifying these abnormalities with BSGM can enable tailored treatment, thus improving clinical outcomes.
1. doi.org/10.1101/2024.05.13.24307307