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African Journal of Paediatric Surgery

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Postoperative Feeding Difficulties after Repair of Congenital Diaphragmatic Hernias

O Adejuyigbe, RG Buick, P Gornal, JJ Corkery

Abstract


Objectives:The study aims to define the incidence, causes and outcome of treatment of feeding difficulties in the immediate post operative period following surgical correction of congenital diaphragmatic hernias {CDH).

Methodology: This was a retrospective study. It involved the review of the case notes of all children diagnosed with congenital diaphragmatic hernia at the Birmingham Children's Hospital (BCH) England over a ten year period, 1982-1991. The feeding difficulties and associated problems noticed postoperatively were extracted from the case notes.

Results: There were 97 children treated for CDH. Sixty four of these children survived. Of these, 24 (37.5%) developed feeding difficulties in the immediate post operative period. The causes of the feeding difficulties were Gastro-oesophageal reflux (GOR) 9, Recurrent diaphragmatic hernia 8, Adhesive intestinal obstruction 4, Poor intestinal motility 2, Campylobacter enteritis, 1, Hypertrophic pyloric stenosis, 1. Many if the children had more than one cause for their feeding problem. Howevert in 6 of the 24 children no cause could be found.

Two of the 24 with feeding difficulties died and 3had lingering feeding difficulties in spite of appropriate surgical and medical treatment.One of these 3 had GOR while the other 2 had adhesive intestinal obstruction in association with recurrence of the diaphragmatic hernia.

Conclusions: Feeding difficulties were very common following the repair of congenital diaphragmatic hernias in children at the BCH. They were a cause of considerable postoperative morbidity.

The occurrence of adhesive intestinal obstruction with recurrent diaphragmatic hernia in the same patient was associated with a poor prognosis in the children in the series.
KEY WORDS: Congenital diaphragmatic hernia; Post operative period
African Journal of Paediatric Surgery Vol.(1)1 2004: 11-15



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