Background Esophageal atresia is a complex esophageal malformation with an incidence of 1 in 3,500–4,000 live births, and it usually occurs together with anomalies in other systems or chromosomes. This study aimed to investigate the short‐term and long‐term results of cases of esophageal atresia retrospectively in our institution and to analyze the factors affecting the outcome. Methods Charts of the patients managed for esophageal atresia in our tertiary pediatric surgery department were investigated retrospectively. Statistical analysis was performed to determine the risk factors for morbidity and mortality. Results One hundred and thirteen (95.8%) of 118 cases underwent a single‐stage or staged esophagoesophagostomy procedure. In only five of the 40 patients with a long gap between the two atretic ends was an esophageal replacement procedure required. The most common early and late complications were anastomotic stenosis (41.6%) and gastroesophageal reflux (44.9%). In logistic regression analysis, the birthweight (OR [95% CI] = 0.998 [0.997, 0.999], P = 0.001) and preoperative inotrope requirement (OR [95% CI] = 13.8 [3.6–53.3], P < 0.001) were the two risk factors in the mortality prediction model obtained by multivariate analysis. The gap length between the two atretic ends (OR [95% CI] = 1.436 [1.010, 2.041], P = 0.044) and the number of sutures for anastomosis (OR [95% CI] = 1.313 [1.042, 1.656], P = 0.021) were the two risk factors in the gastroesophageal reflux prediction model obtained by multivariate analysis. Conclusions Our study's early and late complication rates were like those found in other studies. Identifying risk factors would be beneficial and might help reduce the severity of potential complications in esophageal atresia patients. Prospective studies on large patient series would help develop registry‐based, standardized management protocols.

Mezenterik damarların spontan olarak rüptürü çocuklarda çok nadir bir durumdur. Bu çalışmada travma öyküsü olmaksızın akut karın ve hemorajik şok tablosu ile başvuran 14 yaşında ikiz eşi bir erkek çocuk sunulmaktadır. Acil laparotomide a. mezenterika superiorun rüptüre olduğu saptanmış, onarımı denendiyse de ileri derecede vasküler frajilite nedeni ile başarılamamıştır. Tüm orta barsakta nekroz geliştiğinden, duodenumdan inen kolona kadar geniş rezeksiyon yapılması gerekmiş, duodenal ve kolonik uçlar kapatılmıştır. Ameliyat sonrasında abdominal kompartman sendromu, duodenal fistül ve sepsis gelişen hastada üç hafta içerisinde hem kompartman sendromu, hem de fistül kaybolmuştur. İkiz eşinde ve hastamızdaki atipik yüz görünümü, ince cilt yapısı, kanamaya eğilim bulgularının eşliğinde, yapılan histopatolojik incelemenin de desteği ile ameliyattan 4 hafta sonra Ehler Danlos Sendromu Tip IV tanısı konulabilmiştir. Ameliyat sonrası 3. ayda spontan gelişen femoral arteriovenöz fistül konservatif tedavi edilebilmiş, ancak, hasta ince barsak nakli için bekleme listesinde iken beş ay sonra kaybedilmiştir. Abdominal apopleksi olgularında Ehler Danlos Sendromu akılda tutulmalıdır. Bu olgulardaki vasküler komplikasyonların onarımı tip III kollajen anormalliğine bağlı vasküler frajilite nedeni ile mümkün olmayabilir.

Aim: Although frequency of gastroesophageal reflux (GER) increases after gastrostomy, the role of gastric emptying in GER has not been evaluated. In this study, we examined the effects of Stamm gastrostomy on gastric emptying rate in rats and whether Stamm gastrostomy induces GER or not. Methods: Sprague-Dawley rats were divided into three groups. Stamm gastrostomy was done in the first group (SG). Sham operation was carried out in group 2 and the 3rd group served as control. Gastric emptying was assessed using both liquid and solid meals in each group at postoperative 14th day. For solid meal emptying, after fasting of 16 h, the rats were fed for 3 h and gastric emptying rate was measured at the fifth hour. Methylcellulose was used for emptying of liquids and it was given after the animals were fasted for 16 h and gastric emptying rate was measured 30 min later. Histological evaluation for GER was performed in all groups. Results: GER was observed pathophysiologically in 5 of the 7 rats in SG group. Gastric emptying rates of liquid and solid meals were found to be similar in control, SG or sham groups. Conclusion: Surgical gastrostomy does not affect the gastric emptying of solid and liquid meals in rats. Other mechanisms should be considered in the development of GER observed following gastrostomy.

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