Gastroesophageal reflux disease

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Any one want a high quality PDF of this chart, post in this thread and use a personalized picture as an avatar, I will send it to you in a private message Edit: available without restrictions

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[size=20px]A five-year old neurologically impaired child has developed symptoms of recurrent gastroesophageal reflux disease including vomiting of gastrostomy feedings, failure to thrive and aspiration pneumonia. The patient has undergone a revision Nissen fundoplication one year ago for the same problem. The parents want to know about reasonable treatment options other than another Nissen fundoplication. The option that would best resolve the child recurrent reflux is A surgical jejunostomy tube. B esophagogastric dissociation with Roux-en-Y reconstruction. C transgastric jejunostomy tube. D tracheostomy. E revision Thal fundoplication.​[/size]

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A 2-year old girl is sent for a chest x-ray by her day care after suspicion of swallowing a small toy. The x-ray and subsequent CT scan are shown. She has poor appetite and her weight is at the 10th percentile. She has no other symptoms and her physical examination reveals no abnormalities. How would you manage this?

[size=20px]Which diagnostic study best assesses gastroesophageal reflux and its association with patient symptoms? A Transpyloric feeding trial B Esophagogastroduodenoscopy (EGD) C Upper gastrointestinal series D pH multichannel intraluminal impedance (pH-MII) study E Gastric scintigraphy​[/size]

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[size=20px]A 3-year old boy has severe developmental delay, cerebral palsy, and chronic seizure disorder. He often chokes when fed thick liquids and purees. His weight is currently at the 3rd percentile. He has been maintained on proton pump inhibitors, but still required 3 admissions for aspiration pneumonia over the last year. The parents inquire about the effects of fundoplication on weight gain, discontinuation of reflux medications and hospital admissions. The most adequate response to these queries is that the fundoplication is likely to result in: A weight gain and discontinuation of medications B weight gain with continuation of medications C no weight …

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see video HQ link in second post laparoscopic operation in 7 -year-old boy with malrotation and gastroesophageal reflux disease. It was assumed that gastro-esophageal reflux is secondary to partial obstruction of the duodenum. Intraoperative examination revealed adhesion of the stomach with the front wall of the abdomen and liver (spontaneous - no earlier operations), solid fibrous bands pinching and bending descending part of the duodenum and hiatal hernia. Ladd's bands were released for decompression and straightening the course of the duodenum, appendix was resected (cecum was located in the left upper abdomen) and typical antireflux procedure (Nissen fundoplica…

see video HQ link in second post using polypropylene mesh as a reinforcement material for hiatal crura Operation was carried out in a 13-year old boy after 10 years from the primary laparoscopic fundoplication