PEDIATRICS Vol. 43 No. 4 April 1969, pp. 527-532
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HIATAL HERNIA AND GASTROESOPHAGEAL REFLUX IN CHILDREN

J. Judson McNamara M.D.1, Donald L. Paulson M.D.1, and Harold C. Urschel Jr. M.D.1

1 Department of Thoracic and Cardiovascular Surgery, Baylor University Medical Center, Dallas, Texas

Gastroesophageal reflux, usually with associated hiatal hernia, is recognized as a cause of disabling esophageal and respiratory complications in all age groups; but, until recently, it has been thought to be an unusual problem in infants and children. Respiratory complications, now appreciated with increased frequency in the adult population, may also occur in the pediatric age group.

Thirty patients under 20 years of age with gastroesophageal reflux are presented. Eighteen patients underwent surgical repair. Respiratory complications alone occurred in 3 patients, 2 had only esophageal complications, and 13 had both respiratory and esophageal complications or symptoms as indication for surgery. Symptoms and signs of both respiratory and esophageal complications are tabulated.

Results of medical and surgical therapy are summarized. Surgical patients all represented failure of at least 1 year of medical treatment. Fourteen patients were asymptomatic (excellent result) 6 months to 6 years after surgery. One was considered a good result, one was considered a fair result, and two were considered poor results or failures of surgical treatment.

Results of surgical treatment depends principally on appropriate patient selection. The diagnostic approach particularly in patients with respiratory complications of gastroesophageal reflux is outlined.

The data indicates that many severe recurrent respiratory problems of unexplained etiology in infants and children are due to gastroesophageal reflux and aspiration.

Submitted on May 29, 1968
Accepted on November 15, 1968




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M. Weissbluth
Gastroesophageal Reflux: A Review
Clinical Pediatrics, January 1, 1981; 20(1): 7 - 14.
[Abstract] [PDF]