Total Esophageal Gastric Dissociation for the Failed Antireflux Procedure in a Child with Microgastria

Abstract

Microgastria is a very rare anomaly characterized by a very small tubular stomach that presents with severe gastroesophageal reflux disease due to the small reservoir capacity of the stomach. We present a patient with microgastria-related reflux and a failed fundoplication who was treated with total esophageal gastric dissociation (TEGD) resulting in an excellent outcome. In our experience with this good long-term result, we would suggest that TEGD be added to the armamentarium of procedures that can be used in the treatment of microgastria.

Keywords

microgastria - gastroesophageal reflux - total esophageal gastric dissociation - failed fundoplication

• References

• 1 Ramos CT, Moss RL, Musemeche CA. Microgastria as an isolated anomaly. J Pediatr Surg 1996; 31 (10) 1445-1447
• 2 Kunisaki SM, Dakhoub A, Jarboe MD, Geiger JD. Gastric dissociation for the treatment of congenital microgastria with paraesophageal hiatal hernia. J Pediatr Surg 2011; 46 (6) e1-e4
• 3 Dicken BJ, Novotny NM, Breckler FD, Yim JP, Rescorla FJ. Use of the Hunt-Lawrence pouch in congenital microgastria—a report of 2 cases. J Pediatr Surg 2010; 45 (11) 2238-2240
• 4 Bianchi A. Total esophagogastric dissociation: an alternative approach. J Pediatr Surg 1997; 32 (9) 1291-1294
• 5 Boix-Ochoa J. The physiologic approach to the management of gastric esophageal reflux. J Pediatr Surg 1986; 21 (12) 1032-1039
• 6 Menon P, Rao KL, Cutinha HP, Thapa BR, Nagi B. Gastric augmentation in isolated congenital microgastria. J Pediatr Surg 2003; 38 (10) E4-E6
• 7 Velasco AL, Holcomb III GW, Templeton Jr JM, Ziegler MM. Management of congenital microgastria. J Pediatr Surg 1990; 25 (2) 192-197
• 8 Laurie DE, Wakeling EL. Congenital microgastria in association with Pierre-Robin sequence. Clin Dysmorphol 2008; 17 (2) 143-144
• 9 Stewart C, Stewart M, Stewart F. Microgastria-limb reduction anomaly with total amelia. Clin Dysmorphol 2002; 11 (3) 187-190
• 10 Jones VS, Cohen RC. An eighteen year follow-up after surgery for congenital microgastria—case report and review of literature. J Pediatr Surg 2007; 42 (11) 1957-1960
• 11 Neifeld JP, Berman WF, Lawrence Jr W, Kodroff MB, Salzberg AM. Management of congenital microgastria with a jejunal reservoir pouch. J Pediatr Surg 1980; 15 (6) 882-885
• 12 Islam S, Teitelbaum DH, Buntain WL, Hirschl RB. Esophagogastric separation for failed fundoplication in neurologically impaired children. J Pediatr Surg 2004; 39 (3) 287-291 , discussion 287–291
• 13 Molinaro F, Bindi E, Cerchia E, Angotti R, Mariscoli F, Messina M. Esophagogastric dissociation reduces the re-operation rate for persistent gastroesophageal reflux in severely neurologically impaired children. Pediatr Surg Int 2014; 30 (10) 997-1001
• 14 Morabito A, Lall A, Lo Piccolo R , et al. Total esophagogastric dissociation: 10 years' review. J Pediatr Surg 2006; 41 (5) 919-922
• 15 Lall A, Morabito A, Bianchi A. “Total Gastric Dissociation (TGD)” in difficult clinical situations. Eur J Pediatr Surg 2006; 16 (6) 396-398
• 16 Gatti C, di Abriola GF, Villa M , et al. Esophagogastric dissociation versus fundoplication: which is best for severely neurologically impaired children?. J Pediatr Surg 2001; 36 (5) 677-680
• 17 Buratti S, Kamenwa R, Dohil R, Collins D, Lavine JE. Esophagogastric disconnection following failed fundoplication for the treatment of gastroesophageal reflux disease (GERD) in children with severe neurological impairment. Pediatr Surg Int 2004; 20 (10) 786-790
• 18 Gottrand M, Michaud L, Guimber D , et al. Barrett esophagus and esophagojejunal anastomotic stenosis as complications of esophagogastric disconnection in children with esophageal atresia. J Pediatr Gastroenterol Nutr 2013; 57 (1) 93-95