Barrett esophagus (BE) and intestinal metaplasia of the gastroesophageal junction (IMGEJ) are uncommon in children. The clinicopathologic features and natural history of BE and IMGEJ in children were investigated in this multi-institutional retrospective research. Data from 20 BE patients and 17 IMGEJ patients were acquired retrospectively through chart review. The endoscopic and pathologic results from the index and follow-up endoscopies were studied. The majority of patients had underlying medical problems that put them at risk for gastroesophageal reflux disease. Patients with no underlying illnesses had a higher body mass index (BMI) than those with underlying disorders. The most common histology found in BE and IMGEJ patients was incomplete intestinal metaplasia (IM). The first and follow-up biopsies revealed no dysplasia or cancer. Concurrent stomach biopsies revealed a variety of results, including one IMGEJ patient with concomitant gastric IM. Following up on 12 BE patients revealed that all had prolonged endoscopic illness and 58 had chronic IM histologically. On later operations, three of six IMGEJ patients had endoscopic and histologic characteristics compatible with BE. Furthermore, nongoblet columnar mucosa above the anatomic gastroesophageal junction was seen in a subgroup of BE and IMGEJ patients who underwent endoscopy before the first diagnosis.
In pediatric patients with no underlying illnesses, an increase in BMI may be a risk factor for BE and IMGEJ. Nongoblet columnar metaplasia and IMGEJ may be partial types of BE. According to our findings, these patients should be constantly followed.