Digestive Tract

Abstract Nuclear medicine studies can evaluate functional abnormalities of the digestive tract in children. Repeat episodes of gastroesophageal reflux (GER) are associated with clinical gastrointestinal and/or respiratory manifestations of variable severity. GER scintigraphy, the “milk scan,” can detect GER and aspiration. Clinical signs and symptoms of gastric dysmotility are non-specific and can be related to delayed or, less frequent, rapid gastric emptying (GE). Measurements of GE can be performed with solid and liquid radiolabelled meals and represent the gold standard in gastric dysmotility evaluation. Esophageal transit studies provide information on possible esophageal dysmotility. Failure to identify children with esophageal transit abnormalities may be harmful. For example, if fundoplication is performed on a child with a predominant transit abnormality his symptoms will probably worsen after the surgical procedure. Esophageal transit can be assessed in conjunction with, but preceding, a GER study. Radionuclide salivagram is used for the detection of salivary aspiration. Scanning for detection of a Meckel’s diverticulum can detect ectopic gastric mucosa as the cause and source of gastrointestinal bleeding (GIB) and/or of repeat episodes of abdominal pain in children. Blood pool scintigraphy is also a noninvasive method to determine the presence and gross location of GIB.