Histologic findings in the esophagus in infancy. A contribution to the question of gastroesophageal reflux in sudden infant death

In 53 mortalities (1 stillbirth, 2 neonates, 7 cases up to 5 years of age and 43 SIDS cases), systematic histological investigations were carried out on the esophagus. The results comprised a topography of epithelial defects and inflammatory wall changes. In the SIDS cases, focal epithelial defects could be detected in 14% and fresh inflammatory infiltrates in 7% without preferential localization. There were also lymphocytic reactions of varying extent (62%), but mainly in the upper one-third of the esophagus. Similar findings were found in the 10 non-SIDS cases. The results pattern is discussed with regard to its pathological relevance. It appears to be doubtful that the inflammatory changes are the result of reflux, as reflected in morphological terms.