Document Detail

Management of gastroesfophageal reflux associated with malrotation in children.
MedLine Citation:
PMID:  21292075     Owner:  NLM     Status:  In-Data-Review    
AIM: Children being investigated for gastroesophageal reflux (GOR) have a high incidence of malrotation. Current literature suggests these patients should be managed with a combined antireflux and Ladd's procedure. We review our experience, the largest series to date, of performing an elective Ladd's procedure as the first-line intervention.
METHOD: Retrospective case note review of 20 children with significant symptoms of GOR and an incidental finding of malrotation. Children presenting immediately with bilious vomiting were excluded. All patients underwent a Ladd's procedure as their sole primary operative intervention.
RESULTS: Median age at operation was 7 months (21 days-12 years). Fifteen patients (75%) had evidence of reflux on barium contrast study. All children were followed up for at least 6 months. Eighteen (90%) had resolution or significant improvement of their symptoms postsurgery. Only 3 have not managed to tolerate a full oral diet, all unrelated to GOR. None of our series required an antireflux procedure.
CONCLUSION: In children with debilitating vomiting necessitating surgical management, a contrast study is imperative in the work up. The high incidence of GOR and the significant improvement after correction of malrotation show the relationship between delayed gastric emptying and GOR. We suggest that when an abnormally placed duodenojejunal flexure is found, a Ladd's procedure alone is sufficient and may obviate the need for a more invasive antireflux procedure.
Sonia G Tiboni; Yatin Patel; Anthony D Lander; Dakshesh H Parikh; Girish Jawaheer; G Suren Arul
Related Documents :
8812035 - The sources of children's errors during nonisomorphic analogical transfer: script theor...
21527225 - Safety and efficacy of pcnl for management of staghorn calculi in pediatric patients.
21263015 - N-acetylcysteine as a novel prophylactic treatment for ifosfamide-induced nephrotoxicit...
11418265 - Prenatal exposure to organic solvents and child neurobehavioral performance.
11283435 - Do 9- to 12 yr-old children meet existing physical activity recommendations for health?
18299975 - Differential effects of an adult observer's presence on sex-typed play behavior: a comp...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  46     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  289-91     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  The Aberdeen Medico-Chirurgical Society 1789 to the present day: some leaders in medicine.
Next Document:  Prenatal diagnosis and outcome of fetal lung masses.