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Colonic interposition after esophagogastrectomy in a child with Zollinger-Ellison syndrome
G T Furuta1, R S Bloss, C H Lifschitz
1Department of Pediatrics, Texas Children's Hospital, Houston.
Insights
Zollinger-Ellison syndrome in children, often resistant to treatment, typically requires surgery. A novel colonic interposition procedure offers an alternative to gastrectomy, mitigating common side effects in pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Endocrinology
Background:
- Zollinger-Ellison syndrome is a rare pediatric condition.
- It commonly presents as intractable peptic ulcer disease.
- Standard treatment in adults differs from pediatric cases, where total gastrectomy is preferred.
Observation:
- A pediatric patient with Zollinger-Ellison syndrome developed esophageal stricture.
- This complication presented challenges beyond typical peptic ulcer disease management.
- The patient's condition was resistant to standard medical interventions.
Findings:
- A novel surgical technique involving colonic interposition was successfully employed.
- This procedure addressed both the Zollinger-Ellison syndrome and the esophageal stricture.
- The colonic interposition effectively bypassed the need for a total gastrectomy.
Implications:
- This surgical approach may offer a viable alternative to total gastrectomy in pediatric Zollinger-Ellison syndrome.
- Colonic interposition can potentially reduce the long-term side effects associated with gastrectomy in children.
- Further research is warranted to evaluate the long-term efficacy and safety of this innovative procedure.
Abstract:
Zollinger-Ellison syndrome is a rare childhood entity that usually presents with peptic ulcer disease and is resistant to medical management. In contrast to the treatment of the disease in adults, total gastrectomy is the procedure of choice for pediatric patients. We report on a child with Zollinger-Ellison syndrome complicated by esophageal stricture in whom we performed a new operative procedure using a colonic interposition. The use of the procedure has obviated the side effects commonly associated with gastrectomy.