DUMPING SYNDROME AFTER NISSEN FUNDOPLICATION

Dumping syndrome is infrequently reported in children, but has signifi cant morbidity. It may be difficult both to diagnose and manage. Two c hildren are reported who developed dumping syndrome after Nissen fundo plication. Symptoms occurred soon after the operation and included pos t-prandial pallor, sweating, lethargy and diarrhoea. Failure to thrive was a prominent feature. Typical biochemical changes included hypergl ycaemia shortly after meals, followed by hyperinsulinaemia and reactiv e hypoglycaemia. Effective treatment was only achieved with continuous enteral feeding. Children undergoing fundoplication should be closely monitored for episodes of hypoglycaemia and unresponsiveness. The inc idence of dumping syndrome after fundoplication may be underestimated, particularly in children.