Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enema

Schattenkerk, Robert M.Eeftinck; Schattenkerk, Laurens D. Eeftinck; Musters, Gijsbert D.; Schuppen, Joost van; Jong, Justin R. de; Gorter, Ramon R.; Jonge, Wouter J. de; Heurn, Ernest LW. van; Derikx, Joep P. M.

doi:10.1016/j.jpedsurg.2022.06.013

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…To manage the enterostomy losses and stimulate the adaptation of the distal intestines and colon, chyme re‐infusion could be considered whereby effluents from the proximal enterostomy are re‐infused in the distal intestinal/colon limb if present, 28–31 although this is a logistical challenge. Before starting with chyme re‐infusion, a contrast enema should be made to exclude any distal strictures, particularly in patients with (a history of) necrotic enterocolitis 32 . However, evidence about the value of chyme reinfusion for both children and adults is limited, owing to the often‐times small cohort, different indications, and various re‐infusion techniques and outcomes 31,33 …”

Section: Discussionmentioning

confidence: 99%

“…Before starting with chyme re-infusion, a contrast enema should be made to exclude any distal strictures, particularly in patients with (a history of) necrotic enterocolitis. 32 However, evidence about the value of chyme reinfusion for both children and adults is limited, owing to the often-times small cohort, different indications, and various re-infusion techniques and outcomes. 31,33…”

Section: Conservative Managementmentioning

confidence: 99%

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Systematic review on management of high‐output enterostomy in children: An urgent call for evidence

Stoop,

van Bodegraven,

ten Haaft

et al. 2023

J. pediatr. gastroenterol. nutr.

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Objectives/BackgroundHigh‐output stoma is one of the most common major morbidities in young children with an enterostomy that could lead to intestinal failure. Management of high‐output enterostomy in children is mostly based on personal experience. This systematic review aims to clarify the evidence‐based therapeutic approach of high‐output enterostomy in children.MethodsA systematic review was performed using Pubmed, Embase (Ovid), and Cochrane Library to identify studies published until March 20, 2023, following the 2020 Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline. The study population comprised children (i.e., age <18 years) with high‐output enterostomy (i.e., jejuno‐, ileo‐, and/or colostomy), regardless of underlying aetiology. Interventions comprised any (non)pharmacological and/or surgical treatment. Interventions were compared with each other, placebos, and/or no interventions. Primary outcome was reduction of enterostomy output. Secondary outcomes were morbidity, mortality, quality of life, associated healthcare costs, and adverse events.ResultsThe literature search identified 4278 original articles of which 366 were screened on full text, revealing that none of the articles met the inclusion criteria.ConclusionThis first systematic review on management of high‐output enterostomy in children revealed that any evidence on the primary and secondary outcomes is lacking. There is an urgent need for evidence on conservative treatment strategies including fluid restrictions, dietary advices, oral rehydration solution, chyme re‐infusion, and pharmacological and surgical treatments of high‐output enterostomy in children, aiming to reduce the risk for short‐ and long‐term complications. Till more evidence is available, a systematic and multidisciplinary step‐up approach is needed. Therefore, a therapeutic work‐up is proposed that could guide the care.

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Section: Discussionmentioning

confidence: 99%

Section: Conservative Managementmentioning

confidence: 99%

Systematic review on management of high‐output enterostomy in children: An urgent call for evidence

Stoop,

van Bodegraven,

ten Haaft

et al. 2023

J. pediatr. gastroenterol. nutr.

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Letter to the Editor in response to: Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enema

Bethell

Hallows²

2023

Journal of Pediatric Surgery

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Acquired colonic atresia in children: a report of three cases and review of the literature

Fouad,

Bethell,

Hall

2024

Journal of Surgical Case Reports

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We describe cases of three infants who developed acquired colonic atresia presumed secondary to significant systemic cardiovascular compromise and in the absence of necrotizing enterocolitis. An acquired colonic atresia may present as feed intolerance and should be investigated with a lower gastrointestinal contrast study. We would also recommend routine lower gastrointestinal contrast study prior to stoma closure in an infant with history of significant cardiovascular compromise, even in the absence of significant widespread colonic inflammation such as necrotizing enterocolitis.

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Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enema

Cited by 3 publications

References 21 publications

Systematic review on management of high‐output enterostomy in children: An urgent call for evidence

Systematic review on management of high‐output enterostomy in children: An urgent call for evidence

Letter to the Editor in response to: Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enema

Acquired colonic atresia in children: a report of three cases and review of the literature

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