Purpose or Case Report: Although clinical history seems the most important diagnostic information in gastroesophageal reflux (GER), it is less reliable in pediatric practice, mainly under 2 years old. Diagnostic tests are needed to document the presence of GER and exclude associated conditions. Gastroesophageal ultrasonography (US) is a widely available, noninvasive and sensitive method that provides morphological and functional information in GER diagnosis.

The purpose of this exhibit is:
1. To highlight the main points in the pathophysiology of GER in children;
2. To review the ultrasonographic technique employed in the evaluation of reflux episodes and in the assessment of gastroesophageal junction morphology;
3. To discuss current state of the literature concerning US and pediatric GER.

Ultrasonography cases from our Radiology Department will be employed to illustrate the following topics:
- Clarifying GER and GER disease (GERD) concepts;
- Pathophysiology of GER in children;
- Clinical presentation of GER according to age;
- Diagnostic approaches to pediatric GER;
- The role of US in the management of children with suspected GER;
- The US technique in GER evaluation;
- Understanding the normal gastroesophageal morphology on US;
- Recognizing reflux episodes in US;
- Sonographic assessment of abdominal esophageal length and His angle;
- Literature divergences and recommendations regarding each step of the technique.
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