Affiliation:
1. Department of Paediatric Surgery Glasgow, UK
2. Department of Anaesthesia Royal Hospital for Sick Children, Glasgow, UK
Abstract
The case of a 15 year old female born with multiple anomalies, who subsequently developed severe gastro-intestinal dysmotility is discussed. Motility disorders are often seen in neurologically impaired children, those with a history of gastro-oesophageal reflux disease (GORD), and congenital malformations of the gut. It is characterized by abdominal pain, vomiting and failure to thrive. Once this condition develops, it is difficult to treat. This girl failed to improve with conventional treatment including repeated fundoplication. We hypothesised that her symptoms maybe due to antral dysmotility and sympathetic over-activity. She underwent celiac plexus blockade which was immediately curative but temporary and therefore underwent minimally invasive thoracic splanchnectomy. She continues to be asymptomatic. We discuss the relevant anatomy and management protocol which should be considered in such difficult cases.