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ANATOMIC AND FUNCTIONAL ABNORMALITIES OF THE ESOPHAGUS IN INFANTS SURVIVING CONGENITAL DIAPHRAGMATIC-HERNIA
被引:77
作者
:
STOLAR, CJH
论文数:
0
引用数:
0
h-index:
0
机构:
COLUMBIA PRESBYTERIAN MED CTR,BABIES HOSP,DIV GASTROENTEROL,NEW YORK,NY 10032
STOLAR, CJH
LEVY, JP
论文数:
0
引用数:
0
h-index:
0
机构:
COLUMBIA PRESBYTERIAN MED CTR,BABIES HOSP,DIV GASTROENTEROL,NEW YORK,NY 10032
LEVY, JP
DILLON, PW
论文数:
0
引用数:
0
h-index:
0
机构:
COLUMBIA PRESBYTERIAN MED CTR,BABIES HOSP,DIV GASTROENTEROL,NEW YORK,NY 10032
DILLON, PW
REYES, C
论文数:
0
引用数:
0
h-index:
0
机构:
COLUMBIA PRESBYTERIAN MED CTR,BABIES HOSP,DIV GASTROENTEROL,NEW YORK,NY 10032
REYES, C
BELAMARICH, P
论文数:
0
引用数:
0
h-index:
0
机构:
COLUMBIA PRESBYTERIAN MED CTR,BABIES HOSP,DIV GASTROENTEROL,NEW YORK,NY 10032
BELAMARICH, P
BERDON, WE
论文数:
0
引用数:
0
h-index:
0
机构:
COLUMBIA PRESBYTERIAN MED CTR,BABIES HOSP,DIV GASTROENTEROL,NEW YORK,NY 10032
BERDON, WE
机构
:
[1]
COLUMBIA PRESBYTERIAN MED CTR,BABIES HOSP,DIV GASTROENTEROL,NEW YORK,NY 10032
[2]
COLUMBIA PRESBYTERIAN MED CTR,BABIES HOSP,DIV RADIOL,NEW YORK,NY 10032
来源
:
AMERICAN JOURNAL OF SURGERY
|
1990年
/ 159卷
/ 02期
关键词
:
D O I
:
10.1016/S0002-9610(05)80261-2
中图分类号
:
R61 [外科手术学];
学科分类号
:
摘要
:
As more infants with congenital diaphragmatic hernia (CDH) survive by means of extracorporeal membrane oxygenation (ECMO), new clinical observations are being made. We report anatomic and functional abnormalities of the esophagus in these infants. Twenty-two of 30 infants with CDH survived. Three of 7 non-ECMO-treated infants and 14 of 17 ECMO-treated infants had an air- or fluidfilled mediastinal mass that was confirmed by an upper gastrointestinal series as ectatic esophagus. Contrast studies demonstrated severe gastroesophageal reflux. Intra-esophageal pH monitoring confirmed significant reflux (Euler scores greater than 50) in 69% of tested patients. Prolonged acid clearance in most patients implied abnormal peristalsis. Hydramnios was correlated to the observed esophageal abnormalities, being present in 13 of 16 infants with an available amniotic history. All patients had symptomatic gastroesophageal reflux managed without antireflux surgery and were discharged 36±2 days after initiation of feeding. Follow-up (range: 7 to 56 months; mean: 32 months) showed that weight gain in affected children was slower that weight gain in affected children was slower than in those not affected. All but one are asymptomatic. Repeat upper gastrointestinal series shows persistent ectasia but less gastroesophageal reflux. Gastroesophageal reflux/ectasia is a new observation with CDH. The associated hydramnios may result from proximal foregut obstruction by kinking the gastroesophageal junction with CDH. The radiographic appearance can be quite unusual. Clinical manifestations of gastroesophageal reflux are manageable without surgery but may account for the observed compromised growth. © 1990 Reed Publishing USA.
引用
收藏
页码:204 / 207
页数:4
相关论文
共 11 条
[11]
Toomasian JM., 1988, T AM SOC ART INT ORG, V34, P140
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共 11 条
[11]
Toomasian JM., 1988, T AM SOC ART INT ORG, V34, P140
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1
2
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