Intestinal Anastomotic Ulcers in Children With Short Bowel Syndrome and Anemia Detected by Capsule Endoscopy

Bass, Lee M.; Zimont, Jessica; Prozialeck, Joshua D.; Superina, Riccardo; Cohran, Valeria C.

doi:10.1097/mpg.0000000000000778

Cited by 21 publications

(18 citation statements)

References 22 publications

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“…The diagnosis and treatment of this condition are sometimes difficult and in addition to colonoscopy may need other examination modalities such as enteroscopy and capsule endoscopy. 13 The results of the present study have importance in patient counsel. If the child has undergone several operations as a neonate caretaker, anxiety for the risks of frequent abdominal surgeries at later life may be alleviated.…”

Section: Discussionmentioning

confidence: 60%

Late Abdominal Reoperations after Surgery for Necrotizing Enterocolitis and Spontaneous Intestinal Perforation

2021

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Introduction The aim of this study was retrospective assessment of late major reoperations after surgery for necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) in neonates. Materials and Methods Appropriate ethical consent was obtained. Data collection was by review of hospital records of 165 successive prematures who underwent surgery for NEC (n = 99) or SIP (n = 66) from 1986 to 2019. Outcome measures were late major abdominal surgeries or endoscopies that occurred after the primary surgical treatment, closure of enterostomies, and weaning from parenteral nutrition (PN). We assessed also risk factors for late abdominal surgeries. Results Hundred and twenty-six (76%) patients (NEC, n = 70, 71% and in SIP, n = 56, 85%) survived. Median follow-up was 13 (interquartile range: 5.9–23) years. Nineteen (15%) patients underwent late abdominal surgery with 0% mortality. Most common was surgery for small bowel obstruction (SBO) in 12(9.5%) patients (NEC, n = 5; 7.0%, SIP, n = 7; 13%, p = 0.36) with 10-year cumulative risk of 8.7 (95% confidence interval [CI]: 3.5–14). Long duration of PN and development of intestinal failure associated cholestasis (IFAC) increased the risk of SBO surgery, relative risk: 1.0–3.2 (95% CI: 1.0–9.1), p = 0.02–0.03. Other surgeries included serial transverse enteroplasty (NEC, n = 2), incisional hernia repair (n = 3), cholecystectomy (n = 1), and ovarian torsion (n = 1). Twenty (29%) NEC and four (7%) SIP patients required endoscopic assessment of postoperative symptoms (p = 0.003). Conclusion Late abdominal reoperations occurred in 15% of patients with NEC and SIP with nil mortality. SBO was the main indication. Risk of SBO was similar between NEC and SIP. Long PN and IFAC increased the risk of SBO.

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Section: Discussionmentioning

confidence: 60%

Late Abdominal Reoperations after Surgery for Necrotizing Enterocolitis and Spontaneous Intestinal Perforation

2021

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“…Our search of PubMed from 1992 to 2020 for anastomotic or perianastomotic ulcers in paediatric populations, with the search terms “anastomotic ulcers”, “perianastomotic ulcers”, “infant” and “neonatal”, yielded nine reports in English describing the symptoms of these lesions (Table 1 ) [ 1 , 2 , 4 – 10 ]. Of the 35 cases presented in Table 1 , including ours, two had a sudden onset, while the onset was more gradual in the other cases.…”

Section: Discussionmentioning

confidence: 99%

“…Video capsule endoscopy and double-balloon endoscopy have both been reported to be safe and effective in children as endoscopy methods for the small intestine. Video capsule endoscopy might be useful as postoperative follow-up for children because it is easy and noninvasive, and a patency capsule test can reduce the risk of retention [ 10 – 12 ].…”

Section: Discussionmentioning

confidence: 99%

Ileal Dieulafoy lesion arose 15 years after partial small bowel resection for meconium obstruction of the neonate: a case report

et al. 2021

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Background Anastomotic or perianastomotic ulcers present with symptoms such as chronic anaemia and occult bleeding as long-term complications of bowel resection performed in infancy. Case presentation Herein, we describe a 15-year-old girl with a history of surgery for meconium obstruction without mucoviscidosis in infancy who was hospitalized with chief complaints of presyncope and convulsions. Seven hours after admission, she developed melena and went into shock. An emergency laparotomy was performed, and a Dieulafoy lesion was detected near the site of ileal anastomosis from the surgery that had been performed during infancy. Conclusions Although overt massive lower gastrointestinal bleeding necessitating emergency care is rare in the long term after infant bowel resection, Dieulafoy lesions can cause serious bleeding, requiring rapid life-saving haemostatic procedures.

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“…Due to limited evidence base, no specific treatment is strongly recommended. Various therapies have been tried, 5 including metronidazole, sulfasalazine, mesalamine, budesonide, antacid drugs, cholestyramine and, more recently, local treatment with argon‐plasma coagulation and platelet‐rich fibrin, 3 with only limited success. Indeed, recurrences are frequent and many patients undergo repeated endoscopic or surgical treatments 6 .…”

Section: Discussionmentioning

confidence: 99%

Enteral bleeding in a former preterm girl with short bowel syndrome: Do not miss the diagnosis

Udina

Galimberti

Bramuzzo

et al. 2021

J Paediatrics Child Health

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Intestinal Anastomotic Ulcers in Children With Short Bowel Syndrome and Anemia Detected by Capsule Endoscopy

Abstract: CE may be a helpful adjunctive tool for detecting anastomotic ulcers in patients with SBS and chronic GI blood loss.

Cited by 21 publications

References 22 publications

Late Abdominal Reoperations after Surgery for Necrotizing Enterocolitis and Spontaneous Intestinal Perforation

Late Abdominal Reoperations after Surgery for Necrotizing Enterocolitis and Spontaneous Intestinal Perforation

Ileal Dieulafoy lesion arose 15 years after partial small bowel resection for meconium obstruction of the neonate: a case report

Enteral bleeding in a former preterm girl with short bowel syndrome: Do not miss the diagnosis

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