A 7 year old girl referred for investigation of hypogammaglobulinaemia had hypoalbuminaemia and severe necrotising oesophagitis on oesophagogastroduodenoscopy. Nissen fundoplication resolved all clinical and laboratory abnormalities, but she remains under surveillance because of histological findings of Barrett's oesophagus. Erosive reflux oesophagitis can present with minimal localising symptoms, and hypogammaglobulinaemia and hypoalbuminaemia, presumably from protein loss.
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http://dx.doi.org/10.1136/adc.72.3.245 | DOI Listing |
Am Fam Physician
January 2025
Duke University School of Medicine, Durham, N.C.
Gastroesophageal reflux is a common physiologic event in infants in which gastric contents pass from the stomach into the esophagus. Gastroesophageal reflux may be asymptomatic or cause regurgitation or "spit up." This occurs daily in approximately 40% of infants.
View Article and Find Full Text PDFJ Gastric Cancer
January 2025
Department of Gastroenterological Surgery, Cancer Institute Hospital Ariake, Tokyo, Japan.
Proximal gastrectomy (PG) has reemerged as a viable surgical option for managing proximal gastric cancer and gastroesophageal junction cancer, particularly for early-stage tumors, offering potential advantages over total gastrectomy (TG). This review examines the evolution of PG, emphasizing surgical techniques and outcomes. Although PG was initially abandoned due to postoperative complications such as reflux esophagitis, advances in reconstruction methods, such as the double-flap technique and double-tract reconstruction, have significantly improved patient quality of life and reduced complications.
View Article and Find Full Text PDFLangenbecks Arch Surg
January 2025
Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215008, China.
Background: The selection of an appropriate gastrointestinal (GI) reconstruction procedure after proximal gastrectomy (PG) has long been a challenge. Surgeons have had a long history of exploring anti-reflux gastroesophageal anastomosis. The aim of this article is to systematically summarize the anti-reflux principles of GI reconstructive procedures through a review of the previous literature and to provide a theoretical basis for clinicians to select or innovate procedures.
View Article and Find Full Text PDFInnovations (Phila)
January 2025
Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA.
Objective: The purpose of this study was to assess the 5-year impact of a per oral endoscopic myotomy (POEM) program on both clinical and financial outcomes for our hospital system and the rural community we serve.
Methods: We evaluated the clinical and financial outcomes of all patients who underwent POEM for achalasia. Patients were also contacted by phone to complete the Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) questionnaire postoperatively.
Surg Laparosc Endosc Percutan Tech
January 2025
Department of Surgery, Division of Gastrointestinal Surgery, University of South Florida, Morsani College of Medicine, Tampa, FL.
Background And Aims: Several studies have hypothesized that sparing the oblique/sling fibers during posterior peroral endoscopic myotomy (POEM) may reduce the incidence of gastroesophageal reflux disease (GERD) and reflux esophagitis without compromising the established safety and efficacy of the procedure. This study compares perioperative, postoperative motility-related, and postoperative GERD-related outcomes between posterior oblique/sling fibers-sparing POEM (OFS-POEM) and conventional posterior POEM through a pairwise meta-analysis of comparative studies.
Methods: We conducted a systematic literature review following PRISMA guidelines to identify articles directly comparing posterior OFS-POEM with conventional posterior POEM.
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