1
|
Sabrine BY, Messaoud M, Samia B, Meriem BF, Radhouane BS, Maha BM, Sawsen C, Sami S, Sana M, Amine K, Amel G, Imen Z, Lassaad S, Mongi M, Mohsen B. Outcomes of pneumatic dilation in pediatric caustic esophageal strictures: a descriptive and analytic study from a developing country. Surg Endosc 2023; 37:9291-9298. [PMID: 37884732 DOI: 10.1007/s00464-023-10489-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/23/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVES Corrosive substance ingestion in children represents a significant public health issue due to its long-term health sequelae. Esophageal stricture, main complication of this dangerous condition, is treated by pneumatic dilation and eventually by esophageal replacement. We aimed, through this study, to report the outcomes of esophageal pneumatic dilation complicating corrosive substance ingestion in children in a developing country. METHODS This cross-sectional study was performed on the population of pediatric patients with caustic esophageal stenosis between January 2005 and December 2020. All patients underwent pneumatic balloon dilation. A logistic regression model was built to predict the probability of the occurrence of the event (success/failure) of the dilation. The ROC curve is used to evaluate the performance of the logistic regression model to discriminate between positive and negative values of the dependent variable. RESULTS The success rate of pneumatic balloon dilation was 80.4%. The median duration of overall management was 11 months. The severity of caustic stricture observed during endoscopy was significantly linked to worse outcomes (p = 0.001). Multivariate analysis indicated that the severity of stenosis and the number of dilation sessions were independent risk factors for failure of dilation. ROC curve analysis showed that the area under the curve was 71.7%. A Cut-Off point value of 7 provided the best sensitivity and specificity. CONCLUSION Pneumatic balloon dilation has been proven to be efficacious in infants with caustic esophageal stricture. Pediatric surgeons should take into account factors to promptly switch to replacement surgery and avoid unnecessary and time-consuming serial dilations.
Collapse
Affiliation(s)
- Ben Youssef Sabrine
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia.
| | - Marwa Messaoud
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Belhassen Samia
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Ben Fredj Meriem
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Ben Salah Radhouane
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Ben Mansour Maha
- Anesthesiology Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Chakroun Sawsen
- Anesthesiology Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Sfar Sami
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Mosbahi Sana
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Ksia Amine
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Gara Amel
- Epidemiology and Preventive Medicine Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Zemni Imen
- Epidemiology and Preventive Medicine Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Sahnoun Lassaad
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Mekki Mongi
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| | - Belghith Mohsen
- Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia
| |
Collapse
|
2
|
O'Shea D, Schmoke N, Porigow C, Murray LP, Chung WK, Kattan M, Jang M, Antosy A, Middlesworth W, Khlevner J. Recent Advances in the Genetic Pathogenesis, Diagnosis, and Management of Esophageal Atresia and Tracheoesophageal Fistula: A Review. J Pediatr Gastroenterol Nutr 2023; 77:703-712. [PMID: 37771007 DOI: 10.1097/mpg.0000000000003952] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Infants born with esophageal atresia and tracheoesophageal fistula, a complex congenital malformation occurring in 1/2500-4000 live births, may suffer threats to their cardiac, respiratory, and digestive health in addition to anomalies that may exist in the genitourinary and musculoskeletal systems. Optimal care for these patients throughout their lives is best achieved through a coordinated, multidisciplinary approach that our health care system is not always well-equipped to provide. This review, though not exhaustive, highlights the components of care that pertain to initial surgical reconstruction and subsequent diagnosis and management of the complications that are most frequently encountered. Authors from among the many specialties involved in the care of these patients summarize the current best practice with attention to the most recent advances. Assessment and improvement of quality of life and transition to adult specialists as children grow to adulthood is also reviewed.
Collapse
Affiliation(s)
- Delia O'Shea
- From the Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons/NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY
| | - Nicholas Schmoke
- the Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons/NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY
| | - Chloe Porigow
- the Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons/NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY
| | - Laurie P Murray
- the Division of Pediatric Pulmonology, Department of Pediatrics, Columbia University Irving Medical Center/NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY
| | - Wendy K Chung
- the Department of Pediatrics and Medicine, Columbia University Irving Medical Center, New York, NY
| | - Meyer Kattan
- the Division of Pediatric Pulmonology, Department of Pediatrics, Columbia University Irving Medical Center/NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY
| | - Minyoung Jang
- the Department of Otolaryngology Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons/NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY
| | - Alexandra Antosy
- From the Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons/NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY
| | - William Middlesworth
- the Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons/NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY
| | - Julie Khlevner
- From the Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons/NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY
| |
Collapse
|
3
|
Tawashi K, Tawashi Y, Bashi HO, Al Sharif F, Dalati H. Caustic ingestion leads to pneumonectomy and right colonic interposition, a unique case report. Int J Surg Case Rep 2023; 108:108479. [PMID: 37429200 PMCID: PMC10382806 DOI: 10.1016/j.ijscr.2023.108479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/12/2023] Open
Abstract
INTRODUCTION Corrosive ingestion forms serious problem, with various outcomes depending on the time of diagnosis and treatment. We report here a case with rare and dangerous complications. PRESENTATION OF CASE A two-year-old girl came to our hospital, complaining of solids' dysphagia. Retrieving her medical history showed that she had ingested a corrosive liquid accidentally. Without knowing the nature of the ingested agent, the local doctor removed it, using nasal gastric tube. This procedure induced vomiting, which in turn led to more damage. She stayed in the area's hospital for 40 days with just supportive treatment. The radiological investigations suggested severe stenosis. The dilation was done, but the patient did not respond after three months of treatment. Therefore, a gastrostomy was done. The esophagus replacement was inevitable, but the parents refused the surgical approach. Three months later, she returned to our hospital complaining of a productive cough. The radiological investigations suggested destruction in the left lung with a high suspicion of tracheoesophageal fistula. The treatment was through a surgical approach by removing the damaged lung tissue and closing the tracheoesophageal fistula. The patient got better after a month of the surgery, which allowed us to replace the esophagus and close the tracheoesophageal fistula. DISCUSSION corrosive treatment varies a lot, depending on the patient's situation. Accurate treatment prevents severe and unexpected complications. CONCLUSION More stringent instructions should be enacted among medical providers, corrosive agents' producers, and the public to be more careful when dealing with corrosive chemicals.
Collapse
|
4
|
Friedmacher F. Delayed primary anastomosis for repair of long-gap esophageal atresia: technique revisited. Pediatr Surg Int 2022; 39:40. [PMID: 36482208 PMCID: PMC9732069 DOI: 10.1007/s00383-022-05317-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 12/13/2022]
Abstract
The operative management of patients born with long-gap esophageal atresia (LGEA) remains a major challenge for most pediatric surgeons, due to the rarity and complex nature of this malformation. In LGEA, the distance between the proximal and distal esophageal end is too wide, making a primary anastomosis often impossible. Still, every effort should be made to preserve the native esophagus as no other conduit can replace its function in transporting food from the oral cavity to the stomach satisfactorily. In 1981, Puri et al. observed that in newborns with LGEA spontaneous growth and hypertrophy of the two segments occur at a rate faster than overall somatic growth in the absence of any form of mechanical stretching, traction or bouginage. They further noted that maximal natural growth arises in the first 8-12 weeks of life, stimulated by the swallowing reflex and reflux of gastric contents into the lower esophageal pouch. Since then, creation of an initial gastrostomy and continuous suction of the upper esophageal pouch followed by delayed primary anastomosis at approximately 3 months of age has been widely accepted as the preferred treatment option in most LGEA cases, generally providing good functional results. The current article offers a comprehensive update on the various aspects and challenges of this technique including initial preoperative management and subsequent gap assessment, while also discussing potential postoperative complications and long-term outcome.
Collapse
Affiliation(s)
- Florian Friedmacher
- Department of Pediatric Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| |
Collapse
|
5
|
Sharma K, Sharma S, Gupta DK, Kabra SK, Bajpai M. Functional, nutritional, and developmental assessment of gastric transposition and colonic interposition: Long-term follow-up outcome analysis. J Pediatr Surg 2022; 57:333-341. [PMID: 35680464 DOI: 10.1016/j.jpedsurg.2022.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE The choice of Esophageal replacement (ER) depends on surgeons' preference and patients' anatomical condition. A cross-sectional study was done to compare the long-term outcomes of two methods of ER, Gastric transposition (GT) and Colonic interposition (CI). METHODS Children who had undergone ER from January 1997 to December 2017 with a minimum of two-year post-ER follow-up were evaluated by anthropometry, hepatobiliary scintigraphy, gastroesophageal reflux study, gastric emptying test, pulmonary function test and blood tests. RESULTS Twenty-six (Male:female=17:9) children were recruited. The median age at ER was 13 months (interquartile range 9-40 months) and mean follow-up post-ER was 116.7 ± 76.4 months (range 24-247 months). GT:CI was done in 15(57.7%):11(42.3%) cases. A greater number of abnormal oral contrast studies (p = 0.02) and re-operations (p = 0.05) were documented as baseline characteristics with CI group. The presence of gastroesophageal reflux 9/23(39.1%), duodenogastric reflux 6/24(25%), delayed gastric emptying 6/25(24%), abnormal pulmonary function test 14/22(63.6%) were documented during the study period. However, there was no significant(p>0.05) difference in nutritional, developmental and functional outcomes of both operative methods of ER in the study. CONCLUSION Assessment of nutritional, developmental and functional parameters in children after ER reveals good long-term results. There was no significant difference in CI and GT. LEVEL OF EVIDENCE Comparative study; II.
Collapse
Affiliation(s)
- Kanika Sharma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Room no. 4001, 4th floor, Academic block, New Delhi 110029, India
| | - Shilpa Sharma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Room no. 4001, 4th floor, Academic block, New Delhi 110029, India.
| | - Devendra Kumar Gupta
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Room no. 4001, 4th floor, Academic block, New Delhi 110029, India
| | - Sushil Kumar Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Minu Bajpai
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Room no. 4001, 4th floor, Academic block, New Delhi 110029, India
| |
Collapse
|
6
|
Sarma MS, Tripathi PR, Arora S. Corrosive upper gastrointestinal strictures in children: Difficulties and dilemmas. World J Clin Pediatr 2021; 10:124-136. [PMID: 34868889 PMCID: PMC8603639 DOI: 10.5409/wjcp.v10.i6.124] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/30/2021] [Accepted: 09/19/2021] [Indexed: 02/06/2023] Open
Abstract
Children constitute 80% of all corrosive ingestion cases. The majority of this burden is contributed by developing countries. Accidental ingestion is common in younger children (< 5 years) while suicidal ingestion is more common in adolescents. The severity of injury depends on nature of corrosive (alkali or acid), pH, amount of ingestion and site of exposure. There are multiple doubts and dilemmas which exist in management of both acute ingestion and chronic complications. Acute ingestion leads to skin, respiratory tract or upper gastrointestinal damage which may range from trivial to life threatening complications. Esophagogastroduodenoscopy is an important early investigation to decide for further course of management. The use of steroids for prevention of stricture is a debatable issue. Upper gastrointestinal stricture is a common long-term sequelae of severe corrosive injury which usually develops after three weeks of ingestion. The cornerstone of management of esophageal strictures is endoscopic bougie or balloon dilatations. In case of resistant strictures, newer adjunctive therapies like intralesional steroids, mitomycin and stents can be utilized along with endoscopic dilatation. Surgery is the final resort for strictures resistant to endoscopic dilatations and adjunctive therapies. There is no consensus on best esophageal replacement conduit. Pyloric strictures require balloon dilatation , failure of which requires surgery. Patients with post-corrosive strictures should be kept in long term follow-up due to significantly increased risk of carcinoma. Despite all the endoscopic and surgical options available, management of corrosive stricture in children is a daunting task due to high chances of recurrence, perforation and complications related to poor nutrition and surgery.
Collapse
Affiliation(s)
- Moinak Sen Sarma
- Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
| | - Parijat Ram Tripathi
- Department of Pediatric Gastroenterology, Ankura Hospsital for Women and Children, Hyderabad 500072, Telangana, India
| | - Sachin Arora
- Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
| |
Collapse
|
7
|
Acharya SK, Sugandhi N, Jadhav AK, Bagga D, Tekchandani N, Sreedharan A, Srivastav S, Chakraborty G, Goel P. Gastric pull-up by the retrosternal route for esophageal replacement: Feasibility in a limited-resource scenario. J Pediatr Surg 2021; 56:374-378. [PMID: 32439181 DOI: 10.1016/j.jpedsurg.2020.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The authors herein report the results of esophageal replacement by gastric pull-up technique through the retrosternal route as an option for esophageal replacement in a resource-constrained setup. METHOD Prospectively collected data upon twenty-two consecutive patients (male:female = 17:5) with mean age 24.9 months (7 months-12 years) and mean weight 7.9 kg (4.2-32 kg) who underwent retrosternal gastric pull-up for esophageal atresia (n = 18; 16 atresia with distal fistula & 2 pure atresia) and corrosive injuries to the esophagus (n = 4) over the past 8 years are presented. The management protocol and surgical technique have been described. Observations parameters included indication for esophageal replacement, age at surgery, sex of the child and other demographic details, clinical and operative findings, post-operative outcomes and follow-up details. RESULTS Retrosternal gastric pull-up could be performed in all cases with no mortality or graft loss. Of 22, 20 cases were extubated on-table and 2 cases were extubated within 48 hours of surgery. Mean operative duration was 265 min (range: 175 min to 310 min) and blood loss was 115.3 ml (range: 80-400 ml). Dense vascular adhesions in the region of the esophageal hiatus were encountered in patients with abdominal esophagostomy (n = 4) which were probably related to the local dissection at the time of previous surgery. Minor anastomotic leak was observed in 8 of 22 patients which settled spontaneously over 21 days mean period (range: 18 to 31 days). Antegrade dilatation was required in 3 of 8 cases with minor leak. None of them required revision of anastomosis. Mean follow-up duration is 63 months (range: 11 months - 94 months). Weight gain after surgery was close to or beyond the 25th centile. Symptoms of dumping syndrome or GER were not observed in our cohort. CONCLUSION Our data have demonstrated the safety and feasibility of esophageal replacement by gastric transposition through the retrosternal route in a resource-limited setup. No significant difference has been observed from the results and complications reported in literature for the same procedure. TYPE OF STUDY Prospective observational study / treatment study. LEVEL OF EVIDENCE Level III.
Collapse
Affiliation(s)
- Samir Kant Acharya
- Department of Paediatric Surgery, VM Medical College & Safdarjang Hospital, New Delhi, India
| | - Nidhi Sugandhi
- Department of Paediatric Surgery, VM Medical College & Safdarjang Hospital, New Delhi, India
| | - Amit Kumar Jadhav
- Department of Paediatric Surgery, VM Medical College & Safdarjang Hospital, New Delhi, India
| | - Deepak Bagga
- Department of Paediatric Surgery, VM Medical College & Safdarjang Hospital, New Delhi, India
| | - Narinder Tekchandani
- Department of Paediatric Surgery, VM Medical College & Safdarjang Hospital, New Delhi, India
| | - Anjana Sreedharan
- Department of Paediatric Surgery, VM Medical College & Safdarjang Hospital, New Delhi, India
| | - Saurav Srivastav
- Department of Paediatric Surgery, VM Medical College & Safdarjang Hospital, New Delhi, India
| | - Goutam Chakraborty
- Department of Paediatric Surgery, VM Medical College & Safdarjang Hospital, New Delhi, India
| | - Prabudh Goel
- All India Institute of Medical Sciences, New Delhi, India, PIN 110029.
| |
Collapse
|
8
|
Abstract
BACKGROUND Esophageal replacement is a challenge to the therapeutic skills of surgeons and a technically demanding operation in the pediatric age group. Various conduits and routes have been described in the literature, each with their specific advantages and disadvantages. We carried out this retrospective study to share our experience of esophageal replacement. METHODOLOGY This study was conducted at the department of pediatric surgery The Children's Hospital and The Institute of Child Health, Lahore. The records of patients treated for esophageal replacement were reviewed. The patients under follow-up were called for clinical evaluation and assessed of long terms complications if any. RESULTS A total of 93 patients with esophageal replacement were included in the study. Esophageal replacement was done with gastric transposition in 84 cases (90%), colon interposition in 7 cases (7.5%) including one case of redo colonic interposition, and jejunal interposition in 2 cases (2%). Routes of esophageal replacement were trans-hiatal in 71 (76%), retrosternal in 13 (14%), and trans-hiatal with thoracotomy in 9 (10%) patients. Postoperatively, all of the conduits maintained viability. Wound infection was seen in 10 (11%), wound dehiscence in 5 (5%), anastomotic leak in 9 (10%), anastomotic stenosis in 12 (13%), fistula formation in 4 (4%), aortic injury 1 (1%), dumping syndrome 8 (9%), reflux 18 (19%), dysphagia 15 (16%) and death occurred in 12 patients (13%). CONCLUSION There are problems with esophageal replacement in developing countries. In this context, gastric conduit appeared as the best conduit for esophageal replacement, using the trans-hiatal route for replacement, in the authors' experience.
Collapse
|
9
|
Zeng Z, Zhang H, Liu F. Therapeutic effect of one-stage esophageal replacement with stomach in newborns in the treatment of long-gap esophageal atresia. Minerva Pediatr 2017; 71:547-548. [PMID: 28471144 DOI: 10.23736/s0026-4946.17.04943-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Zhandong Zeng
- Department of Neonatal Surgery, Xuzhou Children's Hospital, Xuzhou Medical University, Jiangsu, China
| | - Hongwei Zhang
- Department of Neonatal Surgery, Xuzhou Children's Hospital, Xuzhou Medical University, Jiangsu, China -
| | - Fengli Liu
- Department of Neonatal Surgery, Xuzhou Children's Hospital, Xuzhou Medical University, Jiangsu, China
| |
Collapse
|
10
|
Chacko A, Masters BI, Isles A. Giant Gastric Bezoar Complicating Congenital Esophageal Atresia Repaired by Gastric Interposition-A Case Report. Front Pediatr 2017; 5:98. [PMID: 28674680 PMCID: PMC5475435 DOI: 10.3389/fped.2017.00098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 04/13/2017] [Indexed: 12/23/2022] Open
Abstract
We describe a giant gastric phytobezoar in a child with repaired congenital esophageal atresia. At age two, a gastric interposition (pull-up) procedure was performed for severe and recurrent esophageal strictures. For 12 months post-gastric interposition, he experienced frequent respiratory illnesses requiring hospital admissions but it was not initially appreciated that these episodes were likely secondary to recurrent aspiration from a gastric bezoar with "spill-over" aspiration.
Collapse
Affiliation(s)
- Archana Chacko
- Department of Respiratory Medicine, Lady Cilento Children's Hospital, Brisbane, QLD, Australia.,The Queensland Children's Medical Research Institute, Brisbane, QLD, Australia.,The University of Queensland, Brisbane, QLD, Australia
| | - Brent I Masters
- Department of Respiratory Medicine, Lady Cilento Children's Hospital, Brisbane, QLD, Australia.,The Queensland Children's Medical Research Institute, Brisbane, QLD, Australia.,The University of Queensland, Brisbane, QLD, Australia
| | - Alan Isles
- Department of Respiratory Medicine, Lady Cilento Children's Hospital, Brisbane, QLD, Australia.,The Queensland Children's Medical Research Institute, Brisbane, QLD, Australia.,The University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|