Gastro-oesophageal reflux and intestinal malrotation in children.
In a series of 74 children undergoing Nissen fundoplication for persistent gastro-oesophageal reflux unresponsive to intensive medical treatment, there was an unexpectedly high incidence (54 per cent, n = 40) of intestinal malrotation. The series was not homogeneous, 25 of the children having reflux as a complication of a serious congenital abnormality (48 per cent incidence of intestinal malrotation), and 49 presenting with 'idiopathic' reflux (57 per cent incidence of intestinal malrotation). Intestinal malrotation is best detected pre-operatively by careful barium radiology, requiring clinicians to be aware of the association. In our experience, in children over the age of 3 months, both an antireflux operation and Ladd's procedure are often necessary to stop gastro-oesophageal reflux when an intestinal malrotation is present.
Kumar
D
D
Department of Surgery, Hospital for Sick Children, London, UK.
Brereton
R J
RJ
Spitz
L
L
Hall
C M
CM
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000601:surgery; D006801:Humans; D007223:Infant; D007422:Intestines / Q000002:abnormalities*