Antireflux cologastric anastomosis following colonic interposition for esophageal replacement

Colon interposition is an accepted method of esophageal replacement in children. Severe symptomatic reflux has occurred in only two of our patients with colonic esophageal substitution. Formation of an antireflux submucosal gastric tunnel eliminated gastrocolic reflux in both patients without impeding normal passage of food into the stomach. © 1986

Lumbar hernia in a case of posterior meningomyelocele

A child with a superior lumbar hernia and a posterior meningomyelocele is described in this report. Although congenital lumbar hernia may be associated with lumbocostal vertebral deficiency syndromes, we believe this patient\u27s condition became obvious due to the repair of the meningomyelocele. This is the first case report of this combination of defects. © 1986 Grune & Stratton, Inc

Treatment of congenital microgastria and dumping syndrome

Two children with congenital microgastria and associated anomalies requiring surgery as infants, developed severe dumping syndrome which necessitated a remedial operation. A Roux-en-Y jejunal pouch (Hunt-Lawrence) was formed at 22 months and 10 months respectively. Weight gain was immediate in both patients and has been sustained for 6 months and 8 years respectively. Symptoms of the dumping syndrome were relieved and the pouch delays filling of the jejunum. © 1983 Grune & Stratton, Inc

Successful management of aberrant subclavian artery-esophageal fistula in an infant

This report describes a 4-month-old female infant with complex congenital heart disease and prolonged nasogastric intubation who developed an aberrant subclavian artery-esophageal fistula that was successfully managed in a two-staged procedure. To our knowledge, this is the first patient to survive correction of this problem after massive hemorrhage. © 1989

Primary (retractile) mesenteritis in a child

We report a case of primary retractile mesenteritis presenting as acute abdominal pain requiring surgery in a 3-year-old boy. At laparotomy, a hemoperitoneum was discovered and the diagnosis of primary mesenteritis was made with the aid of frozen section biopsy of the small bowel mesentery. No resection was necessary, and he made an uneventful recovery and remains well on follow-up. © 1992

Laparoscopic nissen fundoplication in the infant

Twenty-five children weighing less than 8 kg underwent laparoscopic Nissen fundoplication for treatment of refractory gastroesophageal reflux (GER) between January 1993 and April 1995. Mean patient age was 6 months and weight was 5.1 kg. Mean operative time was 114 min, including gastrostomy in 20 patients. Nineteen patients are alive without evidence of GER with a mean follow-up of 359 days. Perioperative complications were unusual and mild. There were 6 late deaths due to progression of underlying disease and not attributable to the procedure. Laparoscopic Nissen fundoplication provides effective antireflux protection to very small children with acceptable morbidity and mortality through short-term follow-up

Experience with bilateral renal artery stenosis as a cause of hypertension in childhood

Since 1981, eight children have been treated at this hospital for hypertension due to bilateral renal artery stenosis (RAS). Useful diagnostic studies were DTPA renal scan following pretreatment with captopril, and selective renal angiography. All patients underwent attempted surgical revascularization of the RAS and three had aortoaortic bypass of an abdominal aortic narrowing. Of the 14 kidneys that had repair of RAS, a successful outcome was obtained in 11 (80%). Three patients required unilateral nephrectomy. Five of eight patients are normotensive and off all medications, and three are normotensive on reduced medication doses. © 1991