Karnak I, Senocak M E, Tanyel F C, Büyükpamukçu N
Department of Pediatric Surgery, Hacettepe University Medical Faculty, Sihhiye, Ankara, Turkey.
Surg Today. 2001;31(11):1005-7. doi: 10.1007/s005950170012.
Gastroesophageal reflux associated with anatomic and functional abnormalities of the esophagus may be encountered following the repair of a congenital diaphragmatic hernia (CDH). We report herein the case of a newborn male infant with CDH found to have an air-filled paravertebral structure. Upper gastrointestinal series confirmed the presence of an ectatic esophagus with poor peristalsis and severe gastroesophageal reflux. The patient required jejunostomy after a safe period of total parenteral nutrition. He tolerated oral feeding following medical treatment without the need for antireflux surgery. The association of dysphagia, esophageal ectasia, and gastroesophageal reflux is rarely seen with CDH, and feeding intolerance is a self-limited disorder that does not usually necessitate antireflux surgery.
先天性膈疝(CDH)修复术后可能会出现与食管解剖和功能异常相关的胃食管反流。我们在此报告一例患有CDH的新生男婴,发现其椎旁结构内有气体。上消化道造影证实存在食管扩张、蠕动功能差和严重的胃食管反流。在全胃肠外营养的安全期过后,该患者需要进行空肠造口术。经过药物治疗后,他能够耐受经口喂养,无需进行抗反流手术。吞咽困难、食管扩张和胃食管反流同时出现的情况在CDH中很少见,喂养不耐受是一种自限性疾病,通常不需要进行抗反流手术。