Esophageal pH Monitoring Abnormalities and Gastroesophageal Reflux Disease in Infants With Intestinal Malrotation

摘要: Hypothesis Infants with rotational abnormalities of the midgut mesentery are at high risk for gastroesophageal reflux disease (GERD) and sudden infant death (SID) from GERD. Design A survey prevalence GERD factor SID in a case series infants treated congenital anomalies that include intestinal malrotation. Eighty-one (89%) studied had mean follow-up 23.2 months (median, 12 months). Setting Patients 2 tertiary care centers consisting children's hospital university medical center. Two hundred eighty-six consecutive were September 1, 1985, through May 31, 1998. The patients selected study 91 who 18- to 24-hour esophageal pH monitoring performed no prior operation on stomach or esophagus. malrotation either alone (n=55) associated repaired abdominal wall defect (n=23) diaphragmatic hernia (n=13). Of infants, 34 asymptomatic time monitoring. Interventions Eighteen- was used determine presence (abnormal score >2 hours postcibal) (type I III pattern combination prolonged duration sleep reflux). Main Outcome Measures reported as clinical outcome subsequent extended Results studied, 80 (88%) 26 (29%) 55 alone, 52 (95%) GERD, 20 (36%) Although found 19 (83%) 23 defects, significantly lower (13% [3 patients]; P =.03) than alone. (69% [9/13]; =.02) but not (23% [3/13]; =.19). Both symptomatic similar prevalences (91% [52/57] vs 82% [28/34]; =.17) (31% [18/57] 24% [8/34]; =.28). On follow-up, prognosis better those initial Conclusions is high, significant concern. hernia. defects have We recommend careful evaluation problems, such SID,