Anti-reflux procedure for difficult-to-treat asthmatic children, case report and literature review

Abstract

Gastroesophageal reflux disease (GERD) is a commonly encountered condition in children, which at times causes respiratory distress, such as asthmatic symptoms, and results in serious morbidity and even mortality. The complexity is sometimes so obscure, that it can cause paradoxical diagnoses and treatment. Here we present two cases of children with difficult-to-treat asthmatic symptoms, which were eventually found to be related to GERD. The two children were treated with anti-reflux procedures and both became symptom free. Literature was also reviewed to shed a light into this complex disease.

Figure 1

In case 2, a hiatus hernia without esophagitis was identified under endoscopy, which was considered as the cause of the boy’s persistent and evident GER and then the difficult-to-treat asthmatic symptom. And this anatomical defect indicates a surgical intervention.