Background: children with cerebral palsy have in 90% of cases impairment in feeding and high risk of early death because of aspiration of food into the lungs. Aim: the aim of the research was to assess, by questionnaires, the quality of life and the nutritional assessment in 30 children with severe neurological impairment fed via gastrostomy (Group A) and in 30 controls oral feeding with the same severe disabilities. Material and Methods: at baseline we evaluated the symptoms, the therapy and the mean weight for age to Z score (SDS). The quality of life has been studied by a questionnaire based on “Cerebral Palsy Quality of Life Questionnaire for Children (CP-QOL-Child)” validated by the international literature. Results: after 6 months of follow-up the mean values of the questionnaire on the quality of life of patients in group A were significantly higher than those in group B (p < 0.002). The mean weight for age Z-score (95% CI) in patients of group A was at the baseline-2.5 (−3.2 and −2.2 extremes) and after 6 months −1.9 (−2.5 and −1.4 extremes) (p < 0.002). There was no change from baseline in patients of group B −2.6 (−3.4 and −2.3 extremes). Conclusion: our results do suggest several benefits associated with the intervention. Weight for age increased to a clinically significant degree over the study period. Parents felt that the intervention had a positive impact on their child's health and in particular on feeding and ease of administration of medications.

An internal hernia is defined as the herniation of viscera through an anatomic or pathologic opening within the confines of the peritoneal cavity. This herniation may be persistent or intermittent. Because of the risk of strangulation of the hernia contents, even small internal hernias are dangerous and may be lethal. Preoperative misdiagnosis has been reported to be elevated. Here, we report and discuss the clinical appearance and treatment approach of an unusual case of a spontaneous left paraduodenal hernia occurred in a child.