[Postoperative follow-up of cardia function in newborn infants after esophageal, diaphragmatic and abdominal wall abnormalities]
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1Kinderchirurgische Klinik, Dr. von Haunerschen Kinderspital der Universität München.
Insights
Postoperative cardial insufficiency in newborns can be effectively screened using pH monitoring. Positive pH monitoring results warrant supplementary X-ray examinations for diagnosis and treatment planning.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Neonatology
Context:
- Neonates undergoing surgical correction for congenital anomalies like esophageal atresia, diaphragmatic defects, or abdominal wall defects are at risk for postoperative cardial insufficiency.
- Accurate postoperative monitoring is crucial for timely intervention and improved outcomes in this vulnerable population.
Purpose:
- To evaluate the utility of long-term pH monitoring and X-ray studies in assessing postoperative cardial insufficiency in newborns.
- To determine the diagnostic accuracy and therapeutic implications of these methods in neonates with congenital surgical conditions.
Summary:
- A study examined 46 newborns post-correction of congenital anomalies between 1986-1989.
- Long-term pH monitoring revealed pathological results in 37.5% (15/40) of cases, while X-ray studies showed abnormalities in 50% (11/22).
- Positive findings led to surgical intervention in 8 cases and conservative therapy in 8 cases, highlighting the role of pH monitoring in guiding treatment.
Impact:
- pH monitoring is a valuable, non-invasive tool for postoperative cardial function screening in neonates, even those of very small size.
- X-ray examinations serve as a crucial supplementary diagnostic tool when pH monitoring results are positive, aiding in therapeutic planning.
Abstract:
From 1986 to 1989 46 newborn were examined after correction of oesophageal atresia, defects of diaphragm or abdominal wall, to record postoperative cardial insufficiency. In 15 of 40 long-time pH metry analysis (37.5%) and in 11 of 22 x-ray studies (50%) a pathological result was found; in 8 times these findings were followed by operation and in 8 times by conservative therapy. pH metry is suitable even in very small newborn for postoperative screening of cardial function; if the results are positive, x-ray examination is supplementary to diagnosis and therapeutical planning.