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En la población pediátrica, los pólipos representan la primera causa de sangrado colorrectal con una prevalencia del 1 %. De ellos, el 90 % corresponde a pólipos juveniles (PJ) .

Case description: A 5-year-old girl presented to the emergency department with a history of foreign body ingestion. A cervico-thoracoabdominal radiograph demonstrate a foreign body in the esophagus, which seemed to show a double rim sign suspecting a button battery. After an emetic episode and expelling a coin, the child became asymptomatic. Close inspection of the X-ray demonstrated that the image was formed by superimposition of 3 circumferential objects of different sizes. Another X-ray observed the persistence of two superimposed objects. Clinical findings: The girl presented with sialorrhea, odynophagia, and nausea. Vital signs and physical examination were normal. There was no significant medical history. Treatment and Outcome: With the suspicion of multiple impacted esophageal objects, the patient was then taken to the operating room. During the flexible esophagoscopy 2 coins were found in the esophagus, both were removed without difficulty. The patient had an uneventful postoperative recovery and there have been no long-term complications. Clinical relevance: Unusual radiographic findings regarding esophageal foreign bodies have been reported, however, we describe the first case of a child with 3 coins impacted in the esophagus and a new radiological finding in foreign bodies ingestions that allow to avoid misdiagnosis and improve outcomes.

Introduction Oesophageal pH-monitoring allows the quantification of gastric reflux episodes in patients with gastroesophageal reflux disease (GERD). The accuracy of the test depends on correct positioning of the pH sensor 5 cm above the lower oesophageal sphincter (LES). The most precise manner to locate the LES is through prior determination by oesophageal manometry. However, because this technique is uncomfortable, mathematical formulas tend to be used in children. Objectives To evaluate the applicability of paediatric formulas to estimate oesophageal length in adults and their effect on diagnostic accuracy. Material and methods A prospective study was carried out in adult patients, in whom the distance between the nasal orifice and the LES was determined by manometry and was compared with the estimated height-related distance calculated by four paediatric formulas (numbered 1–4). We also evaluated the relationship between the position of the probe and the percentage of reflux detected in our series of impedance measurements. Results Formula 1 (9.31 + height in cm × 0.197) was the most accurate (comparison of means −0.38 with 95% CI −0.70/−0.06, p = 0.019). With this formula, none of the patients had estimation errors of ±6 cm. With formulas 2, 3 and 4, the percentage of error was 4.4%, 1.5% and 32.0%, respectively. Conclusion Oesophageal length estimation in adults by using formula 1 is acceptable and can be used in adult patients who refuse to undergo prior manometry.

Resumen Introduccion La pHmetria esofagica permite cuantificar los episodios de reflujo acido en pacientes con enfermedad por reflujo gastroesofagico (ERGE). El posicionamiento adecuado del electrodo de pH a 5 cm por encima del esfinter esofagico inferior (EEI), determina la precision de la prueba. La manera mas exacta para localizar el EEI es mediante su determinacion previa por manometria esofagica, pero es una tecnica molesta, por lo que en ninos tendemos a utilizar formulas matematicas. Objetivos Valorar la aplicabilidad de las formulas pediatricas de estimacion de longitud esofagica en pacientes adultos y su repercusion en la precision diagnostica. Material y metodos Estudio prospectivo en pacientes adultos en el que la distancia desde el borde de la narina hasta el EEI determinada por manometria se ha comparado con la distancia estimada en relacion a la talla calculada por 4 formulas pediatricas (numeradas del 1 al 4). Tambien hemos valorado la relacion entre posicion de la sonda y porcentaje de reflujos detectados en nuestra serie de impedanciometria. Resultados La formula 1 (9,31 + talla cm × 0,197) fue la mas precisa (comparacion de medias −0,38 con IC 95% −0,70 a −0,06, p = 0,019). Con dicha formula, ningun paciente presento errores de estimacion de ± 6 cm. Con las formulas 2, 3 y 4 el porcentaje de error fue del 4,4, del 1,5 y del 32,0%, respectivamente. Conclusion La estimacion de la longitud del esofago en adultos mediante la formula 1 es aceptable y puede usarse en casos en los que el paciente rechace la realizacion de una manometria previa.