Gastroesophageal reflux after repair of congenital diaphragmatic hernia

Kieffer, J; Sapin, Emmanuel; Berg, Alain; Beaudoın, Sylvie; Bargy, F.; Helardot, P. G.

doi:10.1016/0022-3468(95)90497-2

Cited by 99 publications

(63 citation statements)

References 16 publications

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“…On the other hand, use of a prosthetic patch could possibly diminish morbidity related to GERD by lowering the strain on the left crus [96,106]. Furthermore, the diaphragmatic patch may reduce abdominal pressure and facilitate postoperative ventilation [96]. This contrasts with results of other studies reporting that requirement of a patch is an independent determinant that predicts occurrence of GERD [99,107,108].…”

Section: Prediction Of Gerd In Cdh Survivorsmentioning

confidence: 94%

“…Even higher incidences have been reported [32]. The clinical presentation may vary, including recurrent vomiting or regurgitation, recurrent episodes of bradycardia and respiratory arrest, failure to thrive and recurrent pneumonia [96].…”

Section: Incidence Of Gerd In the Short Termmentioning

confidence: 99%

“…Especially when the stomach initially was positioned in the chest, the lack of an intraabdominal esophageal segment following repair would adversely affect the angle of His [71,96]. The combination of increased abdominal-intrathoracal pressure gradient and underdevelopment of the diaphragmatic crus may increase the strain on the crus and result in an insufficient anti-reflux barrier [97] and favorable conditions for hiatus hernia and GERD [96,97].…”

Section: Gastro-intestinal Morbiditymentioning

confidence: 99%

“…According to most studies, the incidence of GERD in the first years after repair ranges between 20 and 72% [33,93,96,[98][99][100]. Even higher incidences have been reported [32].…”

Section: Incidence Of Gerd In the Short Termmentioning

confidence: 99%

“…Yet, GERD appears to some extent to be related to size of the diaphragmatic defect, because it was more frequent and more severe in children requiring a prosthetic patch [100,107] or ECMO [28,32,33]. On the other hand, use of a prosthetic patch could possibly diminish morbidity related to GERD by lowering the strain on the left crus [96,106]. Furthermore, the diaphragmatic patch may reduce abdominal pressure and facilitate postoperative ventilation [96].…”

Section: Prediction Of Gerd In Cdh Survivorsmentioning

confidence: 99%

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The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

et al. 2008

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Congenital diaphragmatic hernia (CDH) is a life-threatening anomaly with a mortality rate of approximately 40-50%, depending on case selection. It has been suggested that new therapeutic modalities such as nitric oxide (NO), high frequency oxygenation (HFO) and extracorporal membrane oxygenation (ECMO) might decrease mortality associated with pulmonary hypertension and the sequelae of artificial ventilation. When these new therapies indeed prove to be beneficial, a larger number of children with severe forms of CDH might survive, resulting in an increase of CDH-associated complications and/or consequences. In follow-up studies of infants born with CDH, many complications including pulmonary damage, cardiovascular disease, gastro-intestinal disease, failure to thrive, neurocognitive defects and musculoskeletal abnormalities have been described. Long-term pulmonary morbidity in CDH consists of obstructive and restrictive lung function impairments due to altered lung structure and prolonged ventilatory support. CDH has also been associated with persistent pulmonary vascular abnormalities, resulting in pulmonary hypertension in the neonatal period.

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Section: Prediction Of Gerd In Cdh Survivorsmentioning

confidence: 94%

Section: Incidence Of Gerd In the Short Termmentioning

confidence: 99%

Section: Gastro-intestinal Morbiditymentioning

confidence: 99%

“…According to most studies, the incidence of GERD in the first years after repair ranges between 20 and 72% [33,93,96,[98][99][100]. Even higher incidences have been reported [32].…”

Section: Incidence Of Gerd In the Short Termmentioning

confidence: 99%

Section: Prediction Of Gerd In Cdh Survivorsmentioning

confidence: 99%

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The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

et al. 2008

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Esophageal pH Monitoring Abnormalities and Gastroesophageal Reflux Disease in Infants With Intestinal Malrotation

Jolley

Lorenz²,

Hendrickson³

et al. 1999

Arch Surg

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Infants with rotational abnormalities of the midgut mesentery are at high risk for gastroesophageal reflux disease (GERD) and for sudden infant death (SID) from GERD. Design: A survey of the prevalence of GERD and the risk factor for SID from GERD in a case series of infants treated for congenital anomalies that include intestinal malrotation. Eighty-one (89%) of the infants studied for GERD had a mean follow-up of 23.2 months (median, 12 months). Setting: Patients treated in 2 tertiary care centers consisting of a children's hospital and a university medical center. Patients: Two hundred eighty-six consecutive infants were treated for congenital anomalies from September 1, 1985, through May 31, 1998. The patients selected for study were 91 infants who had 18-to 24-hour esophageal pH monitoring performed and no prior operation on the stomach or esophagus. The studied infants had intestinal malrotation either alone (n = 55) or associated with a repaired abdominal wall defect (n = 23) or congenital diaphragmatic hernia (n = 13). Of the 91 infants, 34 were asymptomatic at the time of esophageal pH monitoring. Interventions: Eighteen-to 24-hour esophageal pH monitoring was used to determine the presence of GERD (abnormal pH score Ͼ2 hours postcibal) and the risk factor for SID from GERD (type I or III reflux pattern in combination with a prolonged mean duration of sleep reflux). Main Outcome Measures: The prevalence of GERD and the risk factor for SID from GERD. The follow-up of GERD was reported as a combination of clinical outcome and subsequent extended esophageal pH monitoring. Results: Of the 91 infants studied, 80 (88%) had GERD and 26 (29%) had the risk factor for SID from GERD. Of 55 infants with intestinal malrotation alone, 52 (95%) had GERD, and 20 (36%) had the risk factor for SID from GERD. Although GERD was found in 19 (83%) of 23 patients with repaired abdominal wall defects, the prevalence of the risk factor for SID from GERD was significantly lower (13% [3 patients]; P = .03) than in patients with intestinal malrotation alone. The prevalence of GERD in infants with repaired congenital diaphragmatic hernia was significantly lower (69% [9/13]; P = .02) than in infants with intestinal malrotation alone but not for the prevalence of the risk factor for SID from GERD (23% [3/13]; P = .19). Both symptomatic and asymptomatic patients had similar prevalences of GERD (91% [52/57] vs 82% [28/34]; P = .17) and for the risk factor for SID from GERD (31% [18/57] vs 24% [8/34]; P = .28). On followup, the prognosis for GERD in infants with intestinal malrotation was better in the infants who were asymptomatic than in those who were symptomatic at the initial extended esophageal pH monitoring. Conclusions: The prevalence of GERD in infants with intestinal malrotation is high, and the prevalence of the risk factor for SID from GERD is a significant concern. The prevalence of GERD is lower in infants with congenital diaphragmatic hernia. Infants with repaired abdominal wall defects have a lower prevalence of the risk ...

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Noncardiac Problems of the Neonatal Period

Greenberg

2012

Pediatric Cardiovascular Medicine

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Gastroesophageal reflux after repair of congenital diaphragmatic hernia

Cited by 99 publications

References 16 publications

The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

Esophageal pH Monitoring Abnormalities and Gastroesophageal Reflux Disease in Infants With Intestinal Malrotation

Noncardiac Problems of the Neonatal Period

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