The spectrum of diseases of the stomach and duodenum in the pediatric population is broad. Surgical treatment of the pediatric patient requires a thorough understanding and knowledge of developmental biology, in addition to the unique physiologic and pathologic processes. Many…
Benign disorders of the foregut originate in the genes and the environment of the stomach, duodenum, and small intestine. Embryologic events orchestrate anatomic and cellular variations that predispose the adult foregut to obstructive and neoplastic conditions. Webs, stenosis, duplications, and…
Gastric Motility Anatomy and Physiology The gastric fundus, body, antrum, and pylorus must contract and relax in a coordinated manner to produce satisfactory gastric function and emptying ( Figs. 65.1 and 65.2 ). The thinner fundus receptively relaxes to store…
Foreign Body Ingestion Foreign body ingestion is an unusual occurrence. Foreign body ingestion may be intentional or unintentional. There are several ways to classify and consider foreign body ingestion. One way is by type of object (size and shape). Foreign…
Bariatric surgery had its beginnings in the 1950s when malabsorptive operations were performed upon patients with severe hyperlipidemia and obesity. Edward Mason was undoubtedly the father of American bariatric surgery, having first described the gastric bypass in 1969 and later…
Up to 30% of patients who have had operations on the stomach are afflicted with chronic symptoms that have been relegated to the category of postgastrectomy syndromes. This convenient classification is somewhat of a misnomer because some of these patients…
Gastric surgery for benign and malignant diseases has decreased significantly over the last few decades, but the multimodal management of gastric cancer requires that the surgeon be well-versed in the medical and surgical facets of care. The purpose of this…
Zollinger-Ellison syndrome (ZES) was initially described in two index cases of refractory ulcer disease and diarrhea in 1955 at the Ohio State University. The index patients had recurrent peptic ulceration after multiple gastric operations, requiring complete gastrectomy to control their…
Gastroduodenal peptic ulcer disease (PUD) is a common problem with significant geographic variation in prevalence. In Western countries the incidence of PUD has steadily declined. Recent population-based studies have shown a prevalence rate of 4% with 20% of patients having…
Intubation of the gastrointestinal (GI) tract occurs frequently in the course of patient care. Enteral access, whether via the nasal or percutaneous route, is procured in the majority of instances for decompression or nutrition. Intestinal access is indicated for diagnostic…