title: Gastric dysmotility following orthopaedic scoliosis surgery in patients with cerebral palsy: a case series.
abstract: Scoliosis is a common complication in children with cerebral palsy (CP). In these patients, surgical correction carries a high risk of complications. CP is also associated with gastrointestinal dysmotility such as delayed gastric emptying and gastro-oesophageal reflux. We describe 5 patients with CP in whom symptoms of gastric dysmotility clearly exacerbated after orthopaedic scoliosis surgery. They all showed persisting vomiting, nausea, bloating, weight loss, and anorexia necessitating total parental nutrition and/or jejunal feeding. This intensified nutritional support resulted in weight gain. Symptoms, however, persisted in half of the patients. The aetiology of these gastro-intestinal motility problems following scoliosis surgery remains unclear. Mechanical obstruction needs to be ruled out. Delayed gastric emptying may be due to postprandial antral hypomotility as a consequence of sympathic stimulation. Malnutrition could further aggravate gastrointestinal dysmotility. This complication should be taken into account when surgery for spinal deformities in CP patients is planned, especially in patients with pre-existing gastrointestinal motility problems.
authors.affiliation: Department of Paediatric Gastroenterology, University Hospital Ghent, De Pintelaan 185, Ghent, Belgium. Saskia.vandevelde@ugent.be
authors.forename: S
authors.initials: S
authors.lastname: Vande Velde
authors.forename: S
authors.initials: S
authors.lastname: Van Biervliet
authors.forename: R
authors.initials: R
authors.lastname: De Bruyne
authors.forename: K
authors.initials: K
authors.lastname: Van Renterghem
authors.forename: F
authors.initials: F
authors.lastname: Plasschaert
authors.forename: M
authors.initials: M
authors.lastname: Van Winckel
mesh_terms: D000293:Adolescent; D000855:Anorexia / Q000453:epidemiology; D002547:Cerebral Palsy / Q000150:complications*; D005260:Female; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D009325:Nausea / Q000453:epidemiology; D019637:Orthopedic Procedures / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology*; D012600:Scoliosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D014839:Vomiting / Q000453:epidemiology; D015431:Weight Loss