Comparison of the Resting Gastric Secretion of Children and Adults

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Abstract
Examination of the gastric air bubble is a routine procedure preceding the actual introduction of opaque material into the stomach. A lengthened air-fluid interface, in the fasting patient, is generally believed to be a sign of increased gastric secretion. There is little information available as to the actual measurement of this interface in the available textbooks on gastrointestinal radiology or in the usual textbooks of gastroenterology. The apparent increase in the amount of gastric juice may be the result of enhanced secretion or possibly due to delayed emptying of the stomach secondary to an obstructive process. I have been unable, also, to find any reference to the amount of resting gastric secretion in children as related to its appearance in the routine upper gastrointestinal tract examination. Examination of children between five and ten years of age is common in the general pediatric x-ray department, since it is during this period that the complaint of abdominal pain is frequent. It was my impression, after examining patients in this age group, that the length of the air-fluid interface in the fasting stomach was greater than that generally encountered in adults. At first, this was interpreted as a sign of increased hypersecretion secondary to possible duodenal ulceration or other gastric abnormality. In order to test this assumption, some 50 children who had been fasting were compared with a group of adults. By careful questioning of all subjects it was made certain that no fluid had been ingested and, if the results of the examination showed some obstructive disease, the patient was discarded from the series The children's group consisted of those patients coming to the x-ray department for a gastrointestinal series secondary to abdominal pain, for excretory urograms, and for heart examination. The adults were a consecutive group entering the x-ray department for upper gastrointestinal series. Spot films were made outlining the gastric air bubble in all patients preliminary to the ingestion of the opaque material. Fifty-two children with an average age of eight and a half years were examined. The air-fluid interface in this group averaged 2.6 em. The 51 adults, whose average age was fifty-three years, showed an interface of 0.8 cm. (Fig. 1). These findings would suggest that the average amount of resting gastric secretion in children is higher than in adults, and that its appearance cannot of itself be taken as indicative of gastric abnormality. Examination of a true “control” group of children with no gastrointestinal complaints will be undertaken to test the validity of this assumption.

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