Abstract
Vomiting, regurgitation, and dysphagia belong to the typical presenting symptoms and signs of the disorders listed in Table 20.1. For vomiting, time after food intake or during the 24-h cycle, content, and associated symptoms are important additional informations. Regurgitation is often interpreted as vomiting; a precise history and observation yields however that indigestible pieces of food or foreign bodies are brought up in case of regurgitation which get stuck in the esophagus. Dysphagia is defined as getting stuck of a piece of food or as difficult swallowing and is often accompanied by hypersalivation (slobbering, drooling). Some drooling is normal during infancy. The quoted presenting signs occur often combined in the same disorder. They may also be caused by pathologies outside of the upper gastrointestinal tract.
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General, Chest Pain, and Differential Diagnosis
Chial HJ, Camilleri M, Williams DE et al (2003a) Rumination syndrome in children and adolescents: diagnosis, treatment, and prognosis. Pediatrics 111:158–162
Garza JM, Kaul A (2010) Gastroesophageal reflux, eosinophilic esophagitis, and foreign body. Pediatr Clin North Am 57:1331–1345
Section 20.1
Bruch SW, Hirschl RB, Coran AG (2010) The diagnosis and management of recurrent tracheoesophageal fistulas. J Pediatr Surg 45:337–340
Burgos L, Barrena S, Andrés AM, Martinez L, Hernandez F, Olivares P, Lassaletta L, Tovar JA (2010) Colonic interposition for esophageal replacement in children remains a good choice: 33-year median follow-up of 65 patients. J Pediatr Surg 45:341–345
Burjonrappa SC, Youssef S, St-Vil D (2010) What is the incidence of Barret’s and gastric metaplasia in esophageal atresia/tracheoesophageal fistula (EA/TEF) patients? Eur J Pediatr Surg 21:25–29
Harmon CM, Coran AG (1998a) Congenital anomalies of the esophagus. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St Louis
Harrison J, Martin J, Crameri J, Robertson CF, Ranganathan SC (2010) Lung function in children with repaired tracheo-esophageal fistula using the oscillation technique. Pediatr Pulmonol 45:1057–1063
Holland AJ, Fitzgerald DA (2010) Oesophageal atresia and tracheo-oesophageal fistula: current management strategies and complications. Paediatr Respir Rev 11:100–106, quiz 106–107
Holland AJ, Ron O, Pierro A, Drake D, Curry JI, Kiely EM, Spitz L (2009) Surgical outcomes of esophageal atresia without fistula for 24 years at a single institution. J Pediatr Surg 44:1928–1932
Hunter CJ, Petrosyan M, Connelly M, Ford HR, Nguyen NX (2009) Repair of long-gap esophageal atresia: gastric conduits may improve outcome – a 20-year single center experience. Pediatr Surg Int 25:1087–1091
Petrosyan M, Estrada J, Hunter C, Woo R, Stein J, Ford HR, Anselmo DM (2009) Esophageal atresia/tracheoesophageal fistula in very low-birth-weight neonates: improved outcomes with staged repair. J Pediatr Surg 44:2278–2281
Nasr A, McNamara PJ, Mertens L, Levin D, James A, Holtby H, Langer JC (2010) Is routine preoperative 2-dimensional echocardiography necessary for infants with esophageal atresia, omphalocele, or anorectal malformations? J Pediatr Surg 45:876–879
Scott DA (1993–2009) Esophageal atresia/tracheoesophageal fistula overview. In: Pagon RA, Bird TC, Dolan CR, Stephens K (eds) Gene reviews [internet]. University of Washington, Seattle
Serhal L, Gottrand F, Sfeir R, Guimber D, Devos P, Bonnevalle M, Storme L, Turck D, Michaud L (2010) Anastomotic stricture after surgical repair of esophageal atresia: frequency, risk factors, and efficacy of esophageal bougie dilatations. J Pediatr Surg 45:1459–1462
Shah AR, Lazar EL, Atlas AB (2009) Tracheal diverticula after tracheoeosphageal fistula repair: case series and review of the literature. J Pediatr Surg 44:2107–2111
Sistonen SJ, Koivusalo A, Nieminen U, Lindahl H, Lohi J, Kero M, Kärkkäinen PA, Sarna S, Rintala RJ (2010) Esophageal morbidity and function in adults with repaired esophageal atresia with tracheoesophageal fistula: a population-based long-term follow-up. Ann Surg 251:1167–1173
Tannuri U, Tannuri AC, Goncalves ME, Cardoso SR (2008) Total gastric transposition is better than partial tube esophagoplasty for esophageal replacement in children. Dis Esophagus 21:73–77
Section 20.2
Allal H, Captier G, Lopez M, Forgues D, Galifer RB (2001) Evaluation of 142 consecutive laparoscopic fundoplications in children: effects of the learning curve and technical choice. J Pediatr Surg 36:921–926
Al-Salem AH (2007) Congenital pyloric atresia and associated anomalies. Pediatr Surg Int 23:559–563
Berkowitz D, Naveh Y, Berant M et al (1997) “Infantile Colic” as the sole manifestation of gastroesophageal reflux. J Pediatr Gastroenterol Nutr 24:231–233
Boix-Ochoa J, Rowe MI (1998) Gastroesophageal reflux. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St Louis
Campanozzi A, Boccia G, Pensabene L, Panetta F, Marseglia A, Strisciuglio P, Barbera C, Magazzu G, Pettoello-Mantovani M, Staiano A (2009) Prevalence and natural history of gastroesophageal reflux: pediatric prospective survey. Pediatrics 123:779–783
Cohen MC, Ashok D, Gell M, Bishop J, Walker J, Thomson M, Al-Adnani M (2009) Pediatric columnar lined esophagus vs Barrett’s esophagus: is it the time for a consensus definition. Pediatr Dev Pathol 12:116–126
Da Dalt L, Mazzoleni S, Montini G, Donzelli F, Zacchello F (1989) Diagnostic accuracy of pH monitoring in gastro-oesophageal reflux. Arch Dis Child 64:1421–1426
El-Serag HB, Gilger M, Carter J, Genta RM, Rabeneck L (2004) Childhood GERD is a risk factor for GERD in adolescents and young adults. Am J Gastroenterol 99:806–812
El-Serag HB, Gilger MA, Shub MD, Richardson P, Bancroft J (2006) The prevalence of suspected Barrett’s esophagus in children and adolescents: a multicenter endoscopic study. Gastrointest Endosc 64:671–675
Engelmann C, Gritsa S, Gratz KF, Ure BM (2010) Laparoscopic anterior hemifundoplication improves key symptoms without impact on GE in children with and children without neurodevelopmental delays. J Pediatr Gastroenterol Nutr 51:437–442
Estevao-Costa J, Fragoso AC, Prata MJ, Campos M, Trindade E, Dias JA, Brazao AM (2011) Gastric emptying and antireflux surgery. Pediatr Surg Int 27:367–371
Fonkalsrud EW, Ashcraft KW, Coran AG et al (1998) Surgical treatment of gastro-esophageal reflux in children: a combined hospital study of 7467 patients. Pediatrics 101:419–422
Gilger MA, El Serag HB, Gold BD, Dietrich CL, Tsou V, McDuffie A, Shub MD (2008) Prevalence of endoscopic findings of erosive esophagitis in children: a population-based study. J Pediatr Gastroenterol Nutr 47:141–146
Gold BD (2006) Is gastroesophageal reflux disease really a life-long disease: do babies who regurgitate grow up to be adults with GERD complications? Am J Gastroenterol 101:641–644
Hassall E (2008) Step-up and step down approaches to treatment of gastroesophageal reflux disease in children. Curr Gastroenetrol Rep 10:324–331
Hoffman I, Tertychnyy A, Ectors N, De Greef T, Haesendonck N, Tack J (2007) Duodenogastroesopgageal reflux in children with refractory gastro-esophageal reflux disease. J Pediatr 151:307–311
Numanoglu A, Millar AJ, Brown RA, Rode H (2005) Gastroesophageal reflux strictures in children, management and outcome. Pediatr Surg Int 21:631–634
Ramenofsky ML (1986) Gastroesophageal reflux: clinical manifestations and diagnosis. In: Ashcraft KW, Holder TM (eds) Pediatric esophageal surgery. Grune & Stratton, Orlando
Ravelli AM, Panarotto MB, Verdoni L, Consolati V, Bolognini S (2006) Pulmonary aspiration shown by scintigraphy in gastroesophageal reflux-related respiratory disease. Chest 130:1520–1526
Saedon M, Gourgiotis S, Germanos S (2007) Is there a changing trend in surgical management of gastroesophageal reflux disease in children? World J Gastroenterol 13:4417–4422
Soyer T, Karnak I, Tanyel FC, Senocak ME, Ciftci AO, Büyüpanmukcu N (2007) The use of pH monitoring and esophageal manometry in the evaluation of results of surgical therapy for gastroesophageal reflux disease. Eur J Pediatr Surg 17:158–162
Tasker A, Dettmar PW, Panetti M et al (2002) Reflux of gastric juice glue ear in children. Lancet 9:359(9305)–439
Van der Pol RJ, Smits MJ, van Wijk MP et al (2011) Efficacy of proton-pump inhibitors in children with gastroesophageal reflux: a systematic review. Pediatrics 127:925–935
Tovar JA, Luis AL, Encinas JL, Burgos L, Pederiva F, Martinez L, Olivares P (2007) Pediatric surgeons and gastroesophageal reflux. J Pediatr Surg 42:277–283
Vanderhoof JA, Moran JR, Harris CL et al (2003) Efficacy of a pre-thickened infant formula: a multicenter, double-blind, randomized, placebo-controlled parallel group trial in 104 infants with symptomatic gastroesophageal reflux. Clin Pediatr (Phila) 42:483–495
Vicente Y, Hernandez-Peredo G, Molina M, Prieto G, Tovar JA (2001) Acute food bolus impaction without stricture in children with gastroesopgahegal reflux. J Pediatr Surg 36:1397–1400
Section 20.3
Cooper WO, Griffin MR, Arbogast P et al (2002) Very early exposure to erythromycin and infantile hypertrophic pyloric stenosis. Acta Pediatr Adolesc Med 156:647–650
Friedman JN, Goldman RD, Srivastava R et al (2004) Development of a clinical dehydration scale for use in children between 1 and 36 months of age. J Pediatr 1445:201–207
Hernanz-Schulman M, Sells LL, Ambrosino MM, Heller RM, Stein SM, Neblett WW III (1994) Hypertrophic pyloric stenosis in the infant without a palpable olive: accuracy of sonographic diagnosis. Radiology 193:771–776
Lüdtke FE, Bertus M, Michalski S, Dapper FD, Lepsien G (1994) Long-term analysis of ultrasonic features of the antropyloric region 17–27 years after treatment of infantile hypertrophic pyloric stenosis. J Clin Ultra-sound 22:299–305
Mandell GA, Wolfson PJ, Adkins ES et al (1999) Cost-effective imaging approach to the nonbilious vomiting infant. Pediatrics 103:1198–1202
Miozzari HH, Tönz M, von Vigier RO, Bianchetti MG (2001) Fluid resuscitiation in infantile hypertrophic pyloric stenosis. Acta Paediatr 90:511–515
Okoye BE, Parikh DH, Buck RG, Lander AD (2000) Pyloric atresia: five new cases, a new association, and a review of the literature with guidelines. J Pediatr Surg 35:1242–1245
Pfendner EG, Lucky AW (1993–2008 [updated 2009]) Epidermolysis bullosa with pyloric atresia. In: Pagon RA, Bird TD, Dolan CR, Stephens K (eds) Gene reviews [internet]. University of Washington, Seattle
Scherer LR III (1998a) Peptic ulcer and other conditions of the stomach. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St Louis
Schwartz MZ (1998) Hypertrophic pyloric stenosis. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St Louis
Wathen JE, MacKenzie T, Bothner JP (2004) Usefulness of the serum electrolyte panel in the management of pediatric dehydration treated with intravenously administered fluids. Pediatrics 114:1227–1234
Section 20.4
Barohn RJ, Levine EJ, Olson JO, Mendell JR (1988) Gastric hypomotility in Duchenne’s muscular dystrophy. N Engl J Med 319:15–18
Jawaid W, Abdalwahab A, Blair G, Skarsgard E, Webber E (2006) Outcomes of pyloroplasty and pyloric dilatation in children diagnosed with nonobstructive delayed gastric emptying. J Pediatr Surg 41:2059–2061
Machado RS, Yamamoto E, da Silva Patricio FR, Reber M, Kawakami E (2010) Gastric emptying evaluation in children with erosive gastroesophageal reflux disease. Pediatr Surg Int 26:473–478
Medhus AW, Bjornland K, Emblem R, Husebye E (2007) Liquid and solid gastric emptying in adults treated for Hirschsprung’s disease during early childhood. Scand J Gastroenterol 42:34–40
Sharma KK, Ranka P, Goyal P, Dabi DR (2008) Gastric outlet obstruction in children: an overview with report of Jodhpur disease and Sharma’s classification. J Pediatr Surg 43:1891–1897
Singh SJ, Gibbons NJ, Blackshaw PE, Vincent M, J Wakefield, Perkins AC (2006) Gastric emptying of solids in normal children – a preliminary report. J Pediatr Surg 41:413–417
Struijs MC, Lasko D, Somme S, Chiu P (2010) Gastric emptying scans: unnecessary preoperative testing for fundoplications? J Pediatr Surg 45:350–354, discussion 354
Sullivan PB (2008) Gastrointestinal disorders in children with neurodevelopmental disabilities. Dev Disabil Res Rev 14:128–136
Section 20.5
Ashcraft KW (1986) Vascular ring. In: Ashcraft KW, Holder TM (eds) Pediatric esophageal surgery. Grune & Stratton, Orlando
Harmon CM, Coran AG (1998b) Congenital anomalies of the esophagus. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St Louis
Jones DW, Kunisaki SM, Teitelbaum DH, Spigland NA, Coran AG (2010) Congenital esophageal stenosis: the differential diagnosis and management. Pediatr Surg 26:547–551
Section 20.6
Burke CA, Achkar E, Falk GW (1997) Effect of pneumatic dilation on gastroesophageal reflux in achalasia. Dig Dis Sci 42:998–1002
Eckhardt VF, Hoischen T, Bernhard G (2008) Life expectancy, complications, and causes of death in patients with achalasia: results of a 33-year follow-up investigation. Eur J Gastroenterol Hepatol 20:956–960
Jolley SG, Baron HI (1998) Disorders of esophageal function. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol I, 5th edn. Mosby, St Louis
Karnak I, Senocak ME, Tanyel FC, Büyükpamukcu N (2001) Achalasia in childhood: surgical treatment and outcome. Eur J Pediatr Surg 11:223–229
Levine ML, Moskowitz GW, Dorf BS, Bank S (1991) Pneumatic dilation in patients with achalsia with modified Gruntzig dilator (Levine) under direct endoscopic control: results after 5 years. Am J Gastroenterol 86:1581–1584
Orlandi M, Inauen W (2007) “…und plötzlich konnte ich nicht mehr schlucken!” (“…and suddenly I couldn’t swallow any more!”). Schweiz Med Forum 7:333–335
Ortiz A, de Haro LF, Parrilla P, Lage A, Perez D, Munitiz V, Ruiz D, Molina J (2008) Very long-term objective evaluation of Heller myotomy plus posterior partial fundoplication in patients with achalasia of the cardia. Ann Surg 247:258–264
Pasricha PJ, Rai R, Ravich WJ et al (1996) Botulinum toxin for achalasia: long-term outcome and predictors of response. Gastroenterology 110:1410–1415
Tsuboi K, Omura N, Yano F, Kashiwagi H, Kawasaki N, Suzuki Y, Yanaga K (2009) Preoperative dilatation does not affect the surgical outcome of laparoscopic Heller myotomy and Dor fundoplication for esophageal achalasia. Surg Laparosc Endosc Percutan Tech 19:98–100
Section 20.7
Chial HJ, Camilleri M, Williams DE et al (2003b) Rumination syndrome in children and adolescents: diagnosis, treatment, and prognosis. Pediatrics 111:158–162
Mbonda E, Claus D, Bonnier C et al (1995) Prolonged dysphagia caused by congenital pharyngeal dysfunction. J Pediatr 126:923–927
Section 20.8
Campbell JB, Rappaport LN, Skerker LB (1972) Radiology 103:153–156
Jetley NK, Al-Assiri AH, Al Awadi D (2009) Congenital paraesophageal hernia: a 10 year experience from Saudi Arabia. Indian J Pediatr 76:489–493
Mc Intyre RC Jr, Bensard DD, Karrer FM, Hall RJ, Lilly JR (1994) The pediatric diaphragm in acute gastric volvulus. J Am Coll Surg 178:234–238
Scherer LR III (1998b) Peptic ulcer and other conditions of the stomach. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St Louis
Stiefel D, Willi UV, Sacher P, Schwöbel MG, Stauffer UG (2000) Pitfalls in therapy of upside-down stomach. Eur J Pediatr Surg 10:162–166
Section 20.9
Aslan A, Unal I, Karaguzel M, Melikoglu M (2003) A case of intestinal obstruction due to phytobezoar – an alternative surgical approach. Swiss Surg 9:35–37
Chen X, Milkovich S, Stool D, van As AB, Reilly J, Rider G (2006) Pediatric coin ingestion and aspiration. Int J Pediatr Otorhinolaryngol 70:325–329
Johnson DG (1998) Esophagoscopy and other diagnostic techniques. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol I, 5th edn. Mosby, St Louis
Kelley JE, Leech MH, Carr MG (1993) A safe and cost-effective protocol for the magement of esophageal coins in children. J Pediatr Surg 28:898–900
Little DC, Shah SR, St Peter SD, Calkins CM, Morrow SE, Murphy JP, Sharp RJ, Andrews WS, Holcomb GW 3rd, Ostlie DJ, Snyder CL (2006) Esophageal foreign bodies in the pediatric population: our first 500 cases. J Pediatr Surg 41:914–918
Marom T, Goldfarb A, Russo E, Roth Y (2010) Battery ingestion in children. Int J Pediatr Otorhinolaryngol 74:849–854
Paul RI, Jaffe DM (1988) Sharp object ingestions in children: illustrative cases and literature review. Pediatr Emerg Care 4:245–248
Sénéchaud C, Robert JH, Bertin D, Spiliopoulos A (1996) Perforation oesophagienne: quel traitement dans quelle situation? Swiss Surg 2:187–190
Sharp RJ (1986) Esophageal foreign bodies. In: Ashcraft KW, Holder TM (eds) Pediatric esophageal surgery. Grune & Stratton, Orlando
Section 20.10
Elicevic M, Alim A, Tekant GT, Sarimurat N, Adaletli I, Kurugoglu S, Bakan M, Kaya G, Erdogan E (2008) Management of esophageal perforation secondary to caustic esophageal injury in children. Surg Today 38:311–315
Gupta SK, Croffie JM, Fitzgerald JF (2001) Is esophagogastroduodenoscopy necessary in All caustic ingestions ? J Pediatr Gastroenterol Nutr 32:50–53
Kulick RM, Selbst SM, Baker MD, Woodward GA (1988) Thermal epiglottitis after swallowing hot beverages. Pediatrics 81:441–444
Millar AJW, Cywes S (1998) Caustic strictures of the esophagus. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol I, 5th edn. Mosby, St Louis
Nuutinen M, Uhari M, Karvali T, Kouvalainen K (1994) Consequences of caustic ingestion in children. Acta Paediatr 83:1200–1205
Sanchez-Ramirez CA, Larrosa-Haro A, Vasquez Garibay EM, Larios-Arceo F (2011) Caustic ingestion and oesophageal damage in children: clinical spectrum and fee-ding practices. J Paediatr Child Health 47:378–380
Schärli A, Kummer M (1972) Ueber Säureverätzungen des Magens im Kindesalter: Z Kinderchir 11(suppl):493–503
Tokar B, Cevik AA, Ilhan H (2007) Ingested gastrointestinal foreign bodies: predisposing factors for complications in children having surgical or endoscopic removal. Pediatr Surg Int 23:135–39
Smith MT, Wong RK (2006) Esophageal foreign bodies: types and technique for removal. Curr Treat Options Gastroenterol 9:75–84
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Kaiser, G.L. (2012). Vomiting, Regurgitation, and Dysphagia. In: Symptoms and Signs in Pediatric Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-31161-1_20
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