Functional and metabolic evaluation of colon replacement of the esophagus in children.

Thirteen children with esophageal replacement with colon interposition have been followed at the University of Florida Medical Center between 1962 and 1976. Eight of these patients were evaluated with a detailed functional and metabolic protocol, four requiring colon interposition for esophageal atresia and four for esophageal strictures. Growth was noted to be somewhat delayed in the patients with esophageal atresia, especially those with associated congenital anomalies. Otherwise, excellent functional results were obtained. Significant anemia with depressed serum iron concentrations was noted in four patients, and three patients had abnormal vitamin B12 absorption. This abnormality correlated with length of terminal ileum employed with the interposed segment. Serum parameters of intestinal absorption were normal in each patient. Manometric evaluation revealed absence of peristalsis within the colonic segment, but progressive peristalsis within interposed ileal segments. Radiologic evaluation demonstrated delay in passage of thick material from mouth to stomach and wide variability in overall intestinal transit time.