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Gastroesophageal Reflux Disease

  • Thane Blinman
Chapter

Abstract

Few topics in pediatric surgery spark more disagreement and foster more misunderstandings about pathophysiology and management than gastroesophageal reflux disease. The picture is confounded by the differences between small children and adults, the vastly higher energy (and volume) requirements of babies, the preponderance of non-acid reflux, the poorly defined accuracy of the diagnostic tests for reflux, the questionable effectiveness of “anti-reflux” medications, and the variations of technique and experience of surgeons. Further, there are sometimes troubling complications that can occur after anti-reflux surgery, often made worse by feckless attempts to manage the postoperative patients without regard for the mechanical constraints fundoplasty imposes on the performance and regulation of the gastrointestinal tract. It is important to consider GERD as a mechanical disease and ­surgical treatment of reflux as a way to provide a specific mechanical solution, and to take into account the biomechanics of reflux and its amelioration.

Keywords

Gastric Emptying Hiatal Hernia Eosinophilic Esophagitis Peristaltic Wave Esophageal Length 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.General, Thoracic and Fetal SurgeryChildren’s Hospital of PhiladelphiaPhiladelphiaUSA

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