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Oral Presentation - 39
Pilot study: The role of Body Surface Gastric Mapping in evaluating gastric function in children with Oesophageal Atresia
Sadique Raza 1, Gayl Humphrey 2, Daphne Foong 3, Samantha Kelly 4, Stefan Calder 5, Greg O'Grady 2, Vincent Ho 6, Usha Krishnan 7
1 School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
2 Department of Surgery, The University of Auckland, Auckland, New Zealand
3 School of Medicine, Western Sydney University, Sydney, Australia
4 Department of Paediatric Gastroenterology, Sydney Children’s Hospital, Sydney, Australia
5 Alimetry Ltd, Auckland, New Zealand
6 School of Medicine, Western Sydney University, Sydney, Australia, Gastroenterology Department, Campbelltown Hospital, Sydney, Australia
7 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