Salivagram is more likely to detect lung aspiration than gastroesophageal scintigraphy in pediatric patient

Objectives Aspiration is a common cause of pulmonary disease. Traditionally, investigators have emphasized the role of aspiration from gastroesophageal reflux (GER) as an important cause of pulmonary disease in children. Aspiration secondary to GER can be demonstrated by gastroesophageal scintigraphy (milk scan). Aspiration of saliva is less well recognized as a potential etiology for pulmonary disease. Salivagram can be used to evaluate aspiration of saliva. The purpose of this study is to compare the sensitivity of milk scan and salivagram in the detection of aspiration in pediatric patients.

Methods 129 pediatric patients (age between 3 weeks and 16 years, medium age: one year and eight months) received both milk scan and salivagram. The two scans were retrospectively analyzed and compared.

Results In 79.8% of the patients (103/129), milk scan showed gastroesophageal reflux. In 1.6% of the patients (2 of 129), milk scan demonstrated pulmonary aspiration. In 21.7% of the patients (28 of 129), salivagram demonstrated pulmonary aspiration. Lung aspiration was seen in both milk scan and salivagram in 2 patients.

Conclusions Salivagram should be performed before milk scan because it offers a better chance to detect lung aspiration. A further investigation with larger patient number is necessary to assess the validity of our findings