title: Gastric dissociation for the treatment of congenital microgastria with paraesophageal hiatal hernia.
abstract: Microgastria is a rare but well-described congenital anomaly of the alimentary tract that presents in the neonatal period with vomiting, aspiration, and failure to thrive. Based on a relatively small number of case reports, gastric augmentation with a double-barrel loop of jejunum, known as a Hunt-Lawrence pouch, has been advocated as the reconstructive procedure of choice in affected children who fail nonoperative management. In this report, we present a novel method of foregut reconstruction in an infant with congenital microgastria and a paraesophageal hiatal hernia. In this procedure, the stomach was transected 1 cm below the gastroesophageal junction with construction of a straight Roux-en-Y jejunal anastomosis to the gastric fundic cuff. A feeding gastrostomy tube was placed into the distal remnant stomach for enteral access. The patient did well and eventually transitioned to full oral feeds by 3 years of age.
authors.affiliation: Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI 48109, USA. shaunkun@umich.edu
authors.forename: Shaun M
authors.initials: SM
authors.lastname: Kunisaki
authors.forename: Allie
authors.initials: A
authors.lastname: Dakhoub
authors.forename: Marcus D
authors.initials: MD
authors.lastname: Jarboe
authors.forename: James D
authors.initials: JD
authors.lastname: Geiger
mesh_terms: D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging / Q000601:surgery*; D000713:Anastomosis, Roux-en-Y; D002657:Child Development / Q000502:physiology; D004065:Digestive System Abnormalities / Q000175:diagnosis / Q000601:surgery*; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000379:methods; D006551:Hernia, Hiatal / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D018570:Risk Assessment; D013270:Stomach / Q000002:abnormalities* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain