Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI 48109, USA.
J Pediatr Surg. 2011 Jun;46(6):e1-4. doi: 10.1016/j.jpedsurg.2011.02.048.
Microgastria is a rare but well-described congenital anomaly of the alimentary tract that presents in the neonatal period with vomiting, aspiration, and failure to thrive. Based on a relatively small number of case reports, gastric augmentation with a double-barrel loop of jejunum, known as a Hunt-Lawrence pouch, has been advocated as the reconstructive procedure of choice in affected children who fail nonoperative management. In this report, we present a novel method of foregut reconstruction in an infant with congenital microgastria and a paraesophageal hiatal hernia. In this procedure, the stomach was transected 1 cm below the gastroesophageal junction with construction of a straight Roux-en-Y jejunal anastomosis to the gastric fundic cuff. A feeding gastrostomy tube was placed into the distal remnant stomach for enteral access. The patient did well and eventually transitioned to full oral feeds by 3 years of age.
先天性胃小畸形是一种罕见但已被充分描述的消化道先天性畸形，常于新生儿期出现呕吐、吸入和生长不良。基于相对较少的病例报告，对于非手术治疗失败的患儿，推荐使用双筒套叠空肠作为重建手术，即 Hunt-Lawrence 袋。在此报告中，我们介绍了一种在患有先天性胃小畸形和食管旁疝的婴儿中进行前肠重建的新方法。在该手术中，在胃食管交界处下方 1 厘米处横断胃，并将直线 Roux-en-Y 空肠吻合术构建至胃底袖套。将喂养胃造口管放入远端残胃中以进行肠内营养。患者恢复良好，最终在 3 岁时过渡到完全口服喂养。
