An 18-year-old male patient with cerebral palsy and scoliokyphosis came to the emergency department with abdominal distension and vomiting. He was a situs inversus patient with a feeding gastrostomy tube. Sigmoid volvulus was initially suspected, so rectal tube insertion and endoscopic decompression were attempted, but failed. So he went through explorative laparotomy, and transverse colonic adhesion and twisting around the gastrostomy tube and gastric wall was identified. Adhesiolysis and resection with redundant transverse colon and end-to-end colocolic anastomosis was performed. He discharged with symptom free. Suspecting transverse colonic volvulus is important when the patient has anatomical anomalies and feeding gastrostomy tube. Timely diagnosis with proper radiologic imaging should be made. Surgical resection of the redundant colon is needed for successful management of transverse colonic volvulus.

This case report describes a baby who received a laparoscopic gastrostomy tube insertion, which was dislodged accidentally at 16(th) postoperative day. After the dislodgement, cutaneous tract rapidly closed, and reinsertion seemed to be impossible. However, gastrostomy tube was reinserted safely with fluoroscopy-guided Seldinger's technique under local anesthesia with sedation. This is the unique method of modified Seldinger's technique for reinsertion of gastrostomy tube under local anesthesia and sedation for accidentally dislodged gastrostomy tube. This method was thought to be safe, easy and useful technique for gastrostomy reinsertion after dislodgement of gastrostomy tube.

Eleven children with gastroesophageal reflux disease underwent fundoplication. Eight had neurological impairment, two hiatal hernia and one had history of esophageal repair for esophageal atresia. The most common and significant symptom was vomiting (81.8%), followed by recurrent respiratory infections (72.7%) and failure to thrive (72.7%). The most common diagnostic tool was 24 hour esophageal pH study, which showed a pH less than 4 for more than 10% of the total recorded time in 6 among 9 patients. Nissen fundoplication was performed in 10 patients. Thal fundoplication was carried out in one patient with esophageal atresia. Stamm gastrostomy was added for nutritional and/or swallowing problem in all 8 patients with neurological impairment. The median follow up period was 13 months. There were one late death of unrelated cause and one recurrence. The quality of life after antireflux surgery was greatly improved. Antireflux surgery should be done if indicated, and a simultaneous gastrostomy be considered in a patient with neurological impairment.