PEDIATRIC GASTRIC-EMPTYING - VALUE OF RIGHT LATERAL AND UPRIGHT POSITIONING

Gastroesophageal reflux and gastric emptying are usually assessed simu ltaneously with a I-hr procedure, After ingestion of radiolabeled form ula sequential images are gathered when the infant is in the supine po sition, This position is adequate for gastroesophageal reflux assessme nt, but delays gastric emptying, Methods: We studied 48 children, 1 wk to 2 yr of age, who presented with vomiting or failure to thrive, The y received Tc-99m-sulphur colloid in formula. After completing 1 hr su pine imaging we obtained additional abdominal views after changing the position of the infant to right lateral for 30 min, and upright for a nother 30 min, Results: The percent of gastric emptying at 60 min in t he supine position was 35% +/- 19%, At 90 min, in the right lateral de cubitus, the percent gastric emptying was 60% +/- 25%, At 120 min, aft er an upright period, the gastric emptying was 73% +/- 20%, In the sup ine position 19 of 48 patients showed significant emptying (defined as >40% emptying), This increased to 41 of 48 normal studies considering the right lateral position and to 45 of 48 normal studies considering the infant upright position, Conclusion: Many patients with delayed g astric emptying show significant emptying just by changing position, W e routinely complement gastric emptying studies with delayed views in the right lateral and upright position.