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Oral dysfunction following Nissen fundoplication.

S M Borowitz¹, K C Borowitz

¹Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville 22908.

|January 1, 1992

Summary

A child with neurologic impairment experienced severe oral-motor dysfunction after Nissen fundoplication. Reversing the surgery resolved these debilitating symptoms, revealing a new complication of this common procedure.

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Area of Science:

Pediatric Surgery
Gastroenterology
Neurology

Background:

Nissen fundoplication is frequently performed in children with neurologic impairment to manage gastroesophageal reflux.
Postoperative complications can significantly impact a child's quality of life and oral intake.
Oral-motor dysfunction and feeding difficulties are known challenges in this patient population.

Observation:

A child with mild neurologic impairment developed severe gagging, retching, and oral-motor dysfunction post-Nissen fundoplication and gastrostomy tube placement.
All attempts at oral intake were unsuccessful following the initial surgery.
Standard evaluations for postoperative dumping syndrome were negative, and medical/surgical interventions were ineffective.

Findings:

The child's debilitating symptoms of gagging and retching resolved immediately after reversal of the Nissen fundoplication.
Oral-motor function began to improve concurrently with the surgical reversal.
This suggests a direct causal link between the Nissen fundoplication and the observed oral-motor complications.

Implications:

This case report highlights a previously undescribed complication of Nissen fundoplication in children.
The findings suggest that Nissen fundoplication may contribute to or exacerbate oral-motor dysfunction in susceptible pediatric patients.
Further investigation is warranted to understand the mechanism of this complication and inform surgical decision-making.

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