Esophageal dilatation and reflux in neonates supported by ECMO after diaphragmatic hernia repair

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Abstract
Extracorporeal membrane oxygenation (ECMO) for survivors of surgical repair of congenital diaphragmatic hernia was used in 14 neonates. All showed marked esophageal dilatation on postoperative chest radiographs; the dilated esophagus simulated an air- or fluid-filled mass. All patients were later shown to have marked gastroesophageal reflux as well. The finding suggests a problem in swallowing exists before birth, which may explain the recent correlation between diaphragmatic hernia and hydramnios. The observation of a mediastinal mass in neonates with congenital diaphragmatic hernia may represent esophageal ectasia and may be related to significant gastroesophageal reflux.

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