Usefulness of Oesophageal Length Measurement in Paediatric Gastroscopy

Background: The senior author has had a routine of including an oesophageal length measurement routinely at paediatric endoscopy. The authors hypothesise that a short oesophagus predicts reflux changes at pathology.

Aim: This audit seeks to assess the utility of oesophageal length measurement.

Methods: The study is a retrospective chart review. At gastroscopy the distance from the teeth to the squamo-columnar junction is noted. Demographics, oesophageal length, clinical background and pathology data were collected and analysed in an Excel spreadsheet.

Results: 1143 endoscopy reports were reviewed. 823 oesophageal length measurements were available. Mean oesophageal length at 12 months is 21.5 cm, and at 10 years is 33.2 cm. The line of best fit has oesophageal growth ~ 0.1 cm per month from 0 to 16 years. Some degree of inflammation was noted in 313 of 877 pathology reports. The longest and shortest oesophageal length quartiles normalised for height had similar rates of reflux changes on pathology.
As expected oesophageal, length in TOF patients is short, and oesophageal growth slower in TOF than in others. A modest tendency for eosinophilic oesophagitis to correlate with short oesophagus was noted (length difference ~ 0.7cm; p = 0.015).

Discussion: Oesophageal length measurements normalised for both height and age failed to correlate with reflux changes which were nonetheless widespread in TOF patients. There was otherwise no strong relationship between oesophageal length and reflux changes in the general population.

Conclusions: While our measurements seem valid and accurate, their usefulness in predicting reflux pathology in the general population is limited.