{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T13:08:23Z","timestamp":1784725703067,"version":"3.55.0"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antireflux mucosal ablation (ARMA) is a novel, minimally invasive endoscopic technique for the treatment of gastroesophageal reflux disease (GERD). Our case report evaluates the feasibility and early clinical outcomes of ARMA in a neurologically impaired pediatric patient with refractory GERD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case description<\/jats:title>\n                    <jats:p>A 9-year-old boy with spastic cerebral palsy presented with severe GERD refractory to a long-term proton pump inhibitor therapy. He suffered from profound oropharyngeal dysphagia and recurrent aspiration pneumonia requiring multiple hospitalization. An endoscopic ARMA procedure was performed under general anesthesia without intra-procedural complications or immediate adverse events. Early follow-up revealed improved reflux control, enhanced tolerance of gastrostomy feeding, and a reduced need for acid-suppressive therapy. No respiratory deterioration or procedure-related complications were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ARMA is a technically feasible, minimally invasive option for refractory GERD. While this initial case involved a high-risk, neurologically impaired child, the mechanism suggests broader applicability to other pediatric patients with medication-resistant GERD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1812619","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:25:28Z","timestamp":1780291528000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Anti-reflux mucosal ablation (ARMA) as a novel minimally invasive treatment for severe gastroesophageal reflux disease in a child: the first pediatric case report"],"prefix":"10.3389","volume":"14","author":[{"given":"Jonas","family":"Povilavi\u010dius","sequence":"first","affiliation":[{"name":"Vilnius University Faculty of Medicine","place":["Vilnius, Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geist\u0117","family":"Tubutyt\u0117","sequence":"additional","affiliation":[{"name":"Vilnius University Faculty of Medicine","place":["Vilnius, Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil\u0117","family":"Bagdonait\u0117","sequence":"additional","affiliation":[{"name":"Vilnius University Faculty of Medicine","place":["Vilnius, Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrius","family":"Dulskas","sequence":"additional","affiliation":[{"name":"Vilnius University Faculty of Medicine","place":["Vilnius, Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aust\u0117ja","family":"Ra\u010dyt\u0117","sequence":"additional","affiliation":[{"name":"Vilnius University Faculty of Medicine","place":["Vilnius, Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ar\u016bnas","family":"Strumila","sequence":"additional","affiliation":[{"name":"Vilnius University Faculty of Medicine","place":["Vilnius, Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e001577","DOI":"10.1136\/bmjpo-2022-001577","article-title":"Gastro-oesophageal reflux disease in children with neurological impairment: a retrospective cohort study","volume":"6","author":"Dewan","year":"2022","journal-title":"BMJ Paediatr Open"},{"key":"B2","doi-asserted-by":"publisher","first-page":"E133","DOI":"10.1055\/a-1031-9436","article-title":"Anti-reflux mucosal ablation (ARMA) as a new treatment for gastroesophageal reflux refractory to proton pump inhibitors: a pilot study","volume":"8","author":"Inoue","year":"2020","journal-title":"Endosc Int 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