Abstract
Recently, the number of patients with gastroesophageal reflux(GER) after repair of congenital diaphragmatic hernia has been increasing. We experienced a case of GER after two-staged repairs of neonatal gastric rupture and left sac-containing diaphragmatic hernia in a 6-year-old girl. Upper gastrointestinal series before diaphragmatic hernia repair showed that the stomach was located deeply beneath the left elevated diaphragma with a sharp His angle of 12 degrees. She was referred to Ishikawa Prefectural Central Hospital with a chief complaint of hematemesis during the asthma attack. Upper gastrointestinal series showed severe GER with a dull His angle of 108 degrees. After esophagea) manometry. 24-hour esophageal pH monitoring, gastroesophageal scintigraphy and esophgoscopy with biopsy comfirmed the diagnosis of GER and indication for surgical intervention, she underwent a Nissen fundoplication with success. We speculate that a delicate change of His angle after congenital diaphragmatic hernia repair might be a key factor which caused GER in this case.
