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Esophageal atresia and repair and vomiting

J Wang, M Zhang, W Pan, W Wu, W Yan, W Cai
Recurrent tracheoesophageal fistula (rTEF) is a complex complication after the repair of esophageal atresia (EA) and remains a challenge because of difficulties in preoperative management and the substantial rates of mortality and morbidity after reoperation. By reviewing a single institution's experience in the management of rTEF and assessing the outcome, we aimed to provide an optimal approach for managing rTEF and to evaluate growth and feeding problems after reoperations. The medical records of 35 patients with rTEF treated at a single institution from June 2012 to December 2015 were reviewed, and follow-up data were collected from all survivors...
September 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Go Miyano, Shogo Seo, Hiroki Nakamura, Ryo Sueyoshi, Manabu Okawada, Takashi Doi, Hiroyuki Koga, Geoffrey J Lane, Atsuyuki Yamataka
BACKGROUND: We assessed the quality of life (QOL) of postoperative esophageal atresia (EA) with tracheoesophageal fistula (TEF) cases, comparing open with thoracoscopic repair. METHODS: A retrospective review of consecutive EA/TEF repairs (2001-2014) was performed, excluding cases with birth weight less than 2000 g and severe cardiac/chromosomal anomalies. Of 37 cases, 13 had thoracoscopic repair (TR) and 24 had open repair (OR) according to the operating surgeon's preference...
October 2017: Pediatric Surgery International
Lisa Mahoney, Rachel Rosen
Feeding difficulties such as dysphagia, coughing, choking, or vomiting during meals, slow eating, oral aversion, food refusal, and stressful mealtimes are common in children with repaired esophageal atresia (EA) and the reasons for this are often multifactorial. The aim of this review is to describe the possible underlying mechanisms contributing to feeding difficulties in patients with EA and approaches to management. Underlying mechanisms for these feeding difficulties include esophageal dysphagia, oropharyngeal dysphagia and aspiration, and aversions related to prolonged gastrostomy tube feeding...
2017: Frontiers in Pediatrics
Laurent Michaud, Frédéric Coutenier, Guillaume Podevin, Arnaud Bonnard, François Becmeur, Naziha Khen-Dunlop, Frédéric Auber, Aude Maurel, Thomas Gelas, Martine Dassonville, Corinne Borderon, Alain Dabadie, Dominique Weil, Christian Piolat, Anne Breton, Djamal Djeddi, Alain Morali, Florence Bastiani, Thierry Lamireau, Frédéric Gottrand
BACKGROUND: Congenital esophageal stenosis (CES) is a rare condition frequently associated with esophageal atresia (EA). There are limited data from small series about the presentation, treatment, and outcomes of CES. METHODS: Medical records of all patients with CES included in the French Network on Esophageal Malformations and Congenital Diseases were reviewed retrospectively with regard to diagnosis, treatment, and outcome. RESULTS: Over 18 years, 61 patients (30 boys) had CES, and 29 (47%) of these patients also had EA...
December 1, 2013: Orphanet Journal of Rare Diseases
Nicole Wilhelmina Gerarda van Beelen, Daphne S Mous, Erwin Brosens, Annelies de Klein, Cornelis P van de Ven, John Vlot, Hanneke Ijsselstijn, Rene Wijnen
INTRODUCTION: Around half of patients with esophageal atresia (EA) have additional congenital anomalies. Hypertrophic pyloric stenosis (HPS) in these patients is less known, with only 36 cases reported in the past literature. This retrospective study aimed to establish the incidence and clinical presentation of EA patients in combination with HPS in our hospital. MATERIALS AND METHODS: A retrospective study was based on the medical histories from all patients with EA who underwent surgical repair in our hospital from 1988 through 2012...
February 2014: European Journal of Pediatric Surgery
Lincoln O Diniz, Alexander J Towbin
BACKGROUND: Esophageal food bolus impaction is an uncommon entity in the pediatric population that presents with the acute onset of dysphagia, pain, and vomiting. The causes of esophageal food bolus impaction are thought to be different in the pediatric population as compared to adults. AIM: The purpose of this study was to determine the frequency of the different causes of food impaction in patients who undergo an esophagram or upper GI examination. METHODS: The radiology report database was searched to identify all patients with an esophageal food bolus impaction diagnosed on upper GI or esophagram between 1993 and 2009...
March 2012: Digestive Diseases and Sciences
David N Levin, Ivan R Diamond, Jacob C Langer
PURPOSE: The purpose of the study was to compare outcomes after partial vs complete fundoplication in patients with prior esophageal atresia repair. METHODS: All patients undergoing fundoplication following esophageal atresia repair at a tertiary care pediatric hospital from 1987 to 2006 were retrospectively reviewed. All children had at least 1 year of follow-up postfundoplication. RESULTS: Of 47 children, 31 (66%) had a partial fundoplication and 16 (34%) had complete fundoplication...
May 2011: Journal of Pediatric Surgery
Lan-lan Geng, Si-tang Gong, Hai Huang, Wan-er He, Wen-ji Ou, Rui-fang Pan, Xiao-he Huo, Bao-xin Chen
OBJECTIVE: To evaluate the efficacy and safety of balloon dilation (BD) with gastroscope in treatment of esophageal stricture in children. METHODS: BD was performed in 12 children aged 5 - 59 months, average age 26 months, course of disease was 2 - 26 months, with esophageal stricture, 7 cases with anastomotic strictures secondary to surgical repair of esophageal atresia, 3 with congenital esophageal stenosis, 2 with corrosive esophageal strictures. All procedures were performed under tracheal intubation and intravenous anesthesia using the 3rd grade controlled radial expansion (CRE) esophagus-balloon with gastroscope...
December 2008: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
A Mackenzie, G P Frawley
A six-year-old boy with oesophageal strictures secondary to neonatal repair of oesophageal atresia and requiring six to eight weekly oesophageal dilatations by bouginage developed anticipatory nausea and vomiting. This was effectively managed by a course of preoperative hypnotherapy over four sessions. Resolution of anticipatory nausea and vomiting occurred along with cessation of postoperative nausea and vomiting. This case supports early intervention with preoperative hypnotherapy in children with anticipatory nausea and vomiting that has not responded to other measures...
October 2007: Anaesthesia and Intensive Care
P Oğuzkurt, F C Tanyel, M Haliloğlu, A Hiçsönmez
Although infantile hypertrophic pyloric stenosis following esophageal atresia repair is known, infantile hypertrophic pyloric stenosis following H-type tracheoesophageal fistula has not been encountered previously. A case of H-type tracheoesophageal fistula and infantile hypertrophic pyloric stenosis is presented. The patient, operated on for H-type fistula, a rare congenital anomaly of the esophagus, on the tenth day of life was readmitted 19 days later because of continuous vomiting after every feeding. The clinical findings and physical and radiological examinations revealed infantile hypertrophic pyloric stenosis which required surgical treatment...
January 1999: Turkish Journal of Pediatrics
E W Fonkalsrud, M E Ament
Gastroesophageal reflux (GER) is one of the most frequent symptomatic clinical disorders affecting the gastrointestinal tract of infants and children. During the past 2 decades, GER has been recognized more frequently because of an increased awareness of the condition and also because of the more sophisticated diagnostic techniques that have been developed for both identifying and quantifying the disorder. Gastroesophageal fundoplication is currently one of the three most common major operations performed on infants and children by pediatric surgeons in the United States...
January 1996: Current Problems in Surgery
S G Jolley, D G Johnson, C C Roberts, J J Herbst, M E Matlak, A McCombs, P Christian
We studied gastroesophageal reflux (GER) in 25 children between 3 and 83 mo post-repair of esophageal atresia and distal tracheoesophageal fistula (EATEF). The incidence of GER was determined by 18-24 hr pH monitoring of the distal esophagus and gastroesophageal scintiscan following the ingestion of 99mTc sulfur colloid in apple juice. Gastric emptying was also assessed in 20 children. Only 17 of 25 (68%) children had significant GER by esophageal pH monitoring, and 13 of 20 (65%) had significant GER by gastroesophageal scintiscan...
December 1980: Journal of Pediatric Surgery
E E Hrabovsky, M D Mullett
Gastroesophageal reflux (GER) in the pediatric patient is a frequently recognized problem. Unlike the adult, in whom symptoms relating to esophagitis predominate, the infant and child may present with a variety of respiratory problems, vomiting and/or growth failure. GER is often seen in association with other conditions and must be considered in the evaluation of any pediatric patient with chronic recurring respiratory problems, vomiting or failure to thrive (FTT). Thirty-eight pediatric patients have been surgically managed at West Virginia University from 1977-1983 for GER...
April 1985: American Surgeon
K Sumitomo, K Ikeda, A Nagasaki
We treated 3 children with wide-gap esophageal atresia by a circular myotomy of Livaditis technique, after which no postoperative complaints, such as heartburn, vomiting or dysphagia, were seen. Esophageal manometry, performed to evaluate the postoperative esophageal motor function revealed; (1) that lower esophageal sphincter pressure (LESP) increased gradually with time, (2) esophageal contraction waves (ECW) were evident at the site of the circular myotomy with swallowing, though these contractions were simultaneous; and (3) relaxation of the LES with swallowing was evident...
March 1988: Japanese Journal of Surgery
J W Puntis, D G Ritson, C E Holden, R G Buick
Of 230 families belonging to a support group for parents of children born with oesophageal atresia, 124 returned a detailed questionnaire on feeding history and growth. Being slow to feed, refusing meals, coughing or choking during eating, and vomiting at meal times were significantly more common than in 50 healthy control children. Anthropometric analysis indicated that almost one third of patients were growth retarded, although those with a primary oesophageal anastomosis were less likely to be stunted or wasted compared with children who had an oesophageal substitution preceded by an oesophagostomy...
January 1990: Archives of Disease in Childhood
R J Touloukian
End-to-side anastomosis (ES) and ligation of the tracheoesophageal fistula (TEF) has been the procedure of choice for esophageal atresia at our institution since 1967. This report summarizes our operative and long-term results with the ES operation in 68 babies, including 33 in Waterston group A (50%), 23 in group B (35%), and 12 in group C (15%). An additional 10 patients had a primary end-to-end (EE) anastomosis, while 14 others required either staged EE repair or an esophageal replacement procedure. Overall survival rate with ES was 93% including two deaths attributed to major anastomotic leaks and sepsis, and three others in group C from cardiac anomalies...
May 1992: Journal of Pediatric Surgery
S Cavallaro, A Pineschi, G Freni, M G Cortese, T Bardini
Severe feeding troubles were recorded in five babies with long-gap esophageal atresia who underwent, between 1985 and 1990, a delayed primary anastomosis after spontaneous growth of their esophageal stumps. A comparison with 20 cases of direct esophageal anastomosis, operated on in the same period, was carried out by means of recorded esophagrams, pH monitoring and questionnaires charting the growth pattern and feeding habits of the patients. Bottle feeding, and, later on, the introduction of semi-solid foods was significantly retarded in the group of children with delayed primary anastomosis (labeled as group B) as well as height and weight parameters...
April 1992: European Journal of Pediatric Surgery
M H Schatzlein, T V Ballantine, S Thirunavukkarasu, J F Fitzgerald, J L Grosfeld
Eighty-three infants and children underwent surgical correction of gastroesophageal reflux (GER) from 1973 to 1978. Fifty-four patients had coexistent brain damage (most commonly due to cerebral palsy), eight were previously treated for esophageal atresia, and four had gastroschisis or omphalocele repair. Clinical presentation included failure to thrive in 64 patients, vomiting in 59, and recurrent bouts of aspiration pneumonitis in 43. Barium roentgenography showed GER in 61 patients, whereas additional tests (particularly pH monitoring) were required for detection of GER in 22 patients...
April 1979: Archives of Surgery
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