title: Gastrointestinal sequelae in survivors of congenital diaphragmatic hernia.
abstract: BACKGROUND
  Gastrointestinal sequelae have been sporadically reported in survivors of congenital diaphragmatic hernia (CDH). The aim of the present paper was to evaluate the gastrointestinal morbidity in infant, adolescent and adult patients who had undergone repair of CDH.
  
  
  METHODS
  Thirty-one of 38 survivors after left-side CDH repair were followed up. They were subdivided in two groups. Group A consisted of 12 patients (39%) with a mean age of 4.5 years and group B, 19 patients (61%) with a mean age of 21.0 years. Patients underwent physical examination, barium meal study, gastroesophageal scintigraphy, esophageal pH monitoring and manometry of the esophagus and stomach. Upper intestinal endoscopy was performed in patients with confirmed gastroesophageal reflux (GER).
  
  
  RESULTS
  All patients were within the normal range for height or weight. A total of 41.7% of group A and 15.8% of group B had typical symptoms suggesting GER. Barium meal study was pathological in 33.3% of group A and 21% of group B patients. In 58% of group A and 42% of group B, GER was documented on scintigraphy. In 41.7% of group A and 47% of group B the time taken for the stomach to empty half of its radioactive content (T(1/2)) was pathological. On 24 h pH monitoring pathological GER was documented in 54.5%, whereas in group B it was present in 33.3%. In 36.4% of group A and 46.7% of group B alteration of peristalsis of the stomach was recorded. Endoscopy showed esophageal pathology in 33%.
  
  
  CONCLUSIONS
  Foregut dysmotility and GER are major sequelae in survivors of CDH repair. Long-term follow up of patients with CDH is recommended.
authors.affiliation: Department of Medical and Surgical Pediatric Sciences, Operative Unit of Pediatric Surgery, University of Messina, Messina, Italy. arenaf@unime.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Arena
authors.forename: Carmelo
authors.initials: C
authors.lastname: Romeo
authors.forename: Sergio
authors.initials: S
authors.lastname: Baldari
authors.forename: Salvatore
authors.initials: S
authors.lastname: Arena
authors.forename: Pietro
authors.initials: P
authors.lastname: Antonuccio
authors.forename: Alfredo
authors.initials: A
authors.lastname: Campennì
authors.forename: Biagio
authors.initials: B
authors.lastname: Zuccarello
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Romeo
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000209:etiology*; D005767:Gastrointestinal Diseases / Q000209:etiology; D005769:Gastrointestinal Motility; D006548:Hernia, Diaphragmatic / Q000150:complications* / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male