Gastric emptying in children with gastroesophageal reflux. I. An estimate of effective gastric emptying

Jolley, Stephen G.; Leonard, Joe C.; Tunell, William P.

doi:10.1016/s0022-3468(87)80590-0

Cited by 48 publications

(19 citation statements)

References 12 publications

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“…In particular, retching is a common problem following Nissen fundoplication and it is been reported in a high percentage (50%) of children requiring redo fundoplication for recurrent reflux. Retching is associated with disturbed gastricelectrical control activity [16], alterations in gastric emptying [17][18][19], and may be related to vagal nerve dysfunction following Nissen fundoplication [16]. Persistent retching might itself lead to wrap disruption due to an increased pressure on the wrap.…”

Section: Discussionmentioning

confidence: 99%

Factors predicting failure of redo Nissen fundoplication in children

et al. 2007

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Recurrence of gastro-oesophageal reflux (GOR) following redo Nissen fundoplication represents a significant clinical problem. The aim of this study was to identify factors predicting failure of redo Nissen fundoplication. The notes of children who underwent redo Nissen fundoplication for recurrent GOR in a single institution between June 1994 and May 2005 were reviewed. Data are reported as median (range), or as numbers of cases. Multiple logistic regression analysis, using type of first fundoplication, neurological status, presence of gastrostomy, age-weight, retching-gas bloat after first fundoplication, associated anomalies, oesophageal atresia and length of follow-up as factors, was used to generate a model to identify factors predicting recurrent vomiting (failure) after redo. Eighty-one children underwent redo Nissen fundoplication 15.9 months (0.2-176) after the initial Nissen fundoplication. In 29, the first Nissen was laparoscopic. Age at redo Nissen fundoplication was 3.3 years (0.3-15.9) and weight 12.8 kg (5-60). Thirty-four children (42%) presented with recurrent vomiting (failure). Overall, the model successfully predicted vomiting (failure) after redo fundoplication (P = 0.009). Open surgery at first fundoplication (P = 0.011) and neurological impairment (P = 0.046) were both significant predictors of redo failure in the model, whereas presence of gastrostomy (P = 0.035) and older-heavier age-weight (P = 0.028) were associated with significantly better results. Retching-gas bloat, associated anomalies and oesophageal atresia were not significant predictors of failure. Redo Nissen fundoplication has a high failure rate. Risk factors are open fundoplication at first operation and neurological impairment. Redo fundoplication after primary laparoscopic Nissen has a lower risk of failure.

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Section: Discussionmentioning

confidence: 99%

Factors predicting failure of redo Nissen fundoplication in children

et al. 2007

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“…Büyüme-gelişme geriliği: Reflü ve kusmalar kalori eksikliğine neden olarak büyüme gelişme geriliğine neden olabilir. (63).…”

Section: Klinik Bulgularunclassified

Esophageal Diseases In Children

Özcan¹

2012

Toraks Cer Bult

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ÖzetÇocuklarda özofagus hastalıkları arasında koroziv özofagus yaralanmaları önlenebilir bir hastalık olmasına rağmen günü-müzde halen önemli bir sağlık sorunudur. Sıklıkla evlerde temizlik için kullanılan kuvvetli bazik sıvıların küçük çocuklar tarafından kaza ile içilmesi sonucu özofagusta yanık ve ağır olgularda geç dönemde darlık ve buna bağlı yutma güçlüğü gelişir. Korozif özofagus darlıklarının standart tedavisi periyodik özofagus dilatasyonlarıdır. Bu dilatasyonlar yara iyileş-mesi süresi olan 1-2 yıl boyunca 3 haftada bir uygulanır. Bu süre sonunda yanıt alınamayan olgularda kolon ya da mide kullanılarak özofagus replasmanı yapılması gerekebilmektedir. Dilatasyon tedavisi dışında kalıp uygulamaları öneril-miş olsa da çocuklar için uygun kalıplar bulunmamaktadır. Çocuklarda koroziv özofagus darlıklarında mortalite nadir olmasına karşın, morbidite oldukça ciddidir ve hayat boyu süren sorunlar yaratabilir. Bu maddelerin paketlenmesi, etiketlenmesi ve kullanımını kısıtlayan kanuni hükümlere ve eğitime büyük ihtiyaç vardır.Çocuklarda yutma güçlüğü ile ortaya çıkan diğer bir özo-fagus hastalığı ise akalazyadır. Akalazya, alt özofagus sfinkteri dinlenme basıncının yüksekliği, yutma esnasında sfinkter gevşemesinde yetersizlik ve özofagus gövdesinde peristaltizm bozukluğu ile karakterize bir özofagus motilite hastalığıdır. Erişkin akalazyasından farklı olarak çocukluk yaş grubunda balon dilatasyon tedavisinin başarı şansı düşüktür, ayrıca tedavi sonunda gastroözofageal reflü gelişebilmek-tedir. Tedavide diğer bir seçenek olan laparoskopik Heller myotomi ise sfinkterdeki obstrüksiyonu tam olarak giderilebilmekte ayrıca ayni seansta eklenen parsiyel antireflü cerrahi prosedürler ile gastroözofageal reflü de önlenebilmektedir.

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“…Delayed gastric emptying may exacerbate GER by prolonging gastric distention and increasing the frequency of transient LES relaxation [39]. However, attempts to correlate gastric emptying with acid GER have been unsuccessful [40,41]. A range of different techniques (marker dilution, ultrasound, radioscintigraphy, and breath tests) have been used to evaluate gastric emptying of different nutrient/non-nutrient liquid meals (milk formula, apple juice, water).…”

Section: Gastric Emptyingmentioning

confidence: 99%

Pathophysiological mechanisms of Gastroesophageal reflux disease in children

Davidson

Omari

2001

Curr Gastroenterol Rep

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Gastroesophageal reflux (GER) is an extremely common pediatric problem, but only in the past few years have we developed a better understanding of its pathophysiology. This is related to the wider use of investigative tools such as flexible endoscopy, 24-hour pH monitoring, and more recently, micromanometric methods and noninvasive breath tests, which have been particularly useful in infants. This paper reviews our current understanding of the esophageal and gastric mechanisms contributing to the pathophysiology of GER. In this context, we also highlight areas where new therapeutic approaches may be beneficial.

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Gastric emptying in children with gastroesophageal reflux. I. An estimate of effective gastric emptying

Cited by 48 publications

References 12 publications

Factors predicting failure of redo Nissen fundoplication in children

Factors predicting failure of redo Nissen fundoplication in children

Esophageal Diseases In Children

Pathophysiological mechanisms of Gastroesophageal reflux disease in children

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