Dysphagia

, Volume 7, Issue 4, pp 234–237 | Cite as

Oral dysfunction following nissen fundoplication

  • Stephen M. Borowitz
  • Kathleen C. Borowitz
Article

Abstract

In this case report we describe a child with mild neurologic impairment who developed debilitating gagging and retching, and severe oralmotor dysfunction following Nissen fundoplication and gastrostomy tube placement. All oral intake ceased after the operation. Evaluation for postoperative dumping syndrome was negative, and the child's symptoms failed to improve despite numerous medical and surgical measures. However, immediately following reversal of the Nissen fundoplication, the child's gagging and retching ceased, and his oral-motor function began to improve. This is a previously undescribed complication of Nissen fundoplication, a surgical procedure commonly employed in children with neurologic impairment.

Key words

Nissen fundoplication Developmental delay Oral-motor function Dysphagia Gastroesophageal reflux Deglutition Deglutition disorders 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Rempel GR, Colwell SO, Nelson RP: Growth in children with cerebral palsy fed via gastrostomy.Pediatrics 82:857–862, 1988PubMedGoogle Scholar
  2. 2.
    Sondheimer JM, Morris BA: Gastroesophageal reflux among severely retarded children.J Pediatr 94:710–714, 1979PubMedCrossRefGoogle Scholar
  3. 3.
    Wesley JR, Coran AG, Sarahan TM, Klein MD, White SF: The need for evaluation of gastroesophageal reflux in brain-damaged children referred for feeding gastrostomy.J Pediatr Surg 16:866–871, 1981PubMedGoogle Scholar
  4. 4.
    Mollitt DL, Golladay ES, Seibert JJ: Symptomatic gastroesophageal reflux following gastrostomy in neurologically impaired patients.Pediatrics 75:1124–1126, 1985PubMedGoogle Scholar
  5. 5.
    Jolley SJ, Smith EI, Tunell WP: Protective antireflux operation with feeding gastrostomy; experience with children.Ann Surg 201:736–740, 1985PubMedGoogle Scholar
  6. 6.
    Fonkalsrud EW, Foglia RP, Ament ME, Berquist W, Vargas F: Operative treatment for the gastroesophageal reflux syndrome in children.J Pediatr Surg 24:525–529, 1989PubMedGoogle Scholar
  7. 7.
    Vane DW, Harmel RP, King DR, Boles ET: The effectiveness of Nissen fundoplication in neurologically impaired children with gastroesophageal reflux.Surgery 98:662–666, 1985PubMedGoogle Scholar
  8. 8.
    Dedinsky GK, Vane DW, Black CT, Turner MK, West KW, Grosfield FL: Complications and reoperation after Nissen fundoplication in childhood.Am J Surg 153:177–183, 1987PubMedCrossRefGoogle Scholar
  9. 9.
    Stringel, G, Delgado M, Guertin L, Cook JD, Maravilla A, Worthen H: Gastrostomy and Nissen fundoplication in neurologically impaired children.J Pediatr Surg 24:1044–1048, 1989PubMedCrossRefGoogle Scholar
  10. 10.
    Negre JB, Markkula HT, Keyrilaninen O, Matikainen M: Nissen fundoplication—results at ten year follow-up.Am J Surg 146:635–638, 1983PubMedCrossRefGoogle Scholar
  11. 11.
    Randolph J: Experience with the Nissen fundoplication for correction of gastroesophageal reflux in infants.Ann Surg 198:579–584, 1983PubMedGoogle Scholar
  12. 12.
    Harnsberger JK, Corey JJ, Johnson DG, Herbst FF: Long-term follow-up of surgery for gastroesophageal reflux in infants and children.J Pediatr 102:505–508, 1983PubMedCrossRefGoogle Scholar
  13. 13.
    Negre JG: Post-fundoplication symptoms—do they restrict the success of Nissen fundoplication?Ann Surg 198:698–700, 1983PubMedGoogle Scholar
  14. 14.
    Jolley SG, Tunell WP, Leonard JC, Hoelzer DF, Smith EI: Gastric emptying in children with gastroesophageal reflux. II. The relationship to retching symptoms following antireflux surgery.J Pediatr Surg 22:927–930, 1987PubMedGoogle Scholar
  15. 15.
    Caulfied ME, Wyllie R, Firor HV: Dumping syndrome in children.J Pediatr 110:212–215, 1987CrossRefGoogle Scholar
  16. 16.
    Papaila JG, Wilmot D, Grosfeld JL, Grosfield FL, Rescarta FJ, West KW, Vane DW: Increased incidence of delayed gastric emptying in children with gastroesophageal reflux.Arch Surg 124:933–936, 1989PubMedGoogle Scholar
  17. 17.
    Jones PM: Peeding disorders in children with multiple handicaps.Dev Med Child Neurol 31:404–406, 1989PubMedCrossRefGoogle Scholar
  18. 18.
    Sochaniwsky AE, Koheil RM, Bablich K: Oral motor functioning, frequency of swallowing and drooling in normal children and in children with cerebral palsy.Arch Phys Med Rehabil 67:866–874, 1986Google Scholar
  19. 19.
    Helfrich-Miller KR, Rector KL, Straka JA: Dysphagia: its treatment in the profoundly retarded patient with cerebral palsy.Arch Phys Med Rehabil 67:520–525, 1986PubMedGoogle Scholar
  20. 20.
    Kenny DJ, Casas MJ, McPherson KA: Correlation of ultrasound imaging of oral swallow with ventilatory alterations in cerebral palsied and normal children: preliminary observations.Dysphagia 4:112–117, 1989PubMedCrossRefGoogle Scholar
  21. 21.
    Jean A: Control of the central swallowing program by inputs from the peripheral receptors.J Auton Nerv Syst 10:225–233, 1984PubMedCrossRefGoogle Scholar
  22. 22.
    Falempin M, Mei N, Rousseau JP: Vagal mechanoreceptors of the inferior thoracic oesophagus, the lower oesophageal sphincter, and the stomach in the sheep.Pflugers Arch 373: 25–30, 1978PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc 1992

Authors and Affiliations

  • Stephen M. Borowitz
    • 1
  • Kathleen C. Borowitz
    • 1
  1. 1.Department of Pediatrics, Divisions of Gastroenterology and Speech PathologyUniversity of Virginia Health Sciences CenterCharlottesvilleUSA

Personalised recommendations