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A Prospective Evaluation

John G. Papaila, MD; David Wilmot, MD; Jay L. Grosfeld, MD; Frederick J. Rescorla, MD; Karen W. West, MD; Dennis W. Vane, MD

Arch Surg. 1989;124(8):933-936.

Abstract
• Symptomatic gastroesophageal reflux is a common cause of failure to thrive, aspiration, and chronic pulmonary infection in infants. Gastric emptying was prospectively evaluated in 99 infants and children with symptomatic gastroesophageal reflux. Twenty-eight (28.2%) of 99 patients with gastroesophageal reflux had delayed gastric emptying. Twenty-one (75%) of the 28 patients underwent a concomitant gastric drainage procedure at the time of fundoplication. Seven had fundoplication alone and developed symptoms of early satiety, gas bloat, gagging, and pain postoperatively. Medical therapy was ineffective in these patients, and 5 improved after pyloroplasty. Delayed gastric emptying is common in patients with gastroesophageal reflux. These findings suggest that after fundoplication, symptoms of gagging, early satiety, and gas-bloat syndrome may be related to delayed gastric emptying. This implies that a gastric emptying study should be performed preoperatively.

(Arch Surg. 1989;124:933-936)

Author Affiliations
From the Section of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine, James Whitcomb Riley Hospital for Children, Indianapolis.

Footnotes
Accepted for publication February 28, 1989.

Read before the 96th Annual Meeting of the Western Surgical Association, San Diego, Calif, November 16, 1988.

Reprint requests to James Whitcomb Riley Hospital for Children, 702 Barnhill Dr (K21), Indianapolis, IN 46223 (Dr Grosfeld).

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