Anastomotic ulcers in short bowel syndrome: New suggestions from a multidisciplinary approach
| Autor: | Renato Tambucci, Paola Francalanci, Pietro Bagolan, Filippo Torroni, Fabio Fusaro, Stefano Ceccarelli, Antonella Diamanti, Paola De Angelis, Erminia Romeo, Andrea Pietrobattista, Dominique Hermans, Luigi Dall'Oglio |
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| Přispěvatelé: | UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service de pédiatrie générale |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Short Bowel Syndrome medicine.medical_specialty Adolescent Argon plasma coagulation 03 medical and health sciences 0302 clinical medicine Risk Factors 030225 pediatrics Small intestinal bacterial overgrowth Bowel ischemic injury medicine Humans Medical history Child Ulcer Retrospective Studies business.industry Gastroschisis Short bowel syndrome Anastomosis Surgical Anastomotic ulceration Infant Newborn Gestational age Infant Endoscopic treatment General Medicine medicine.disease Surgery Parenteral nutrition Child Preschool Pediatrics Perinatology and Child Health Settore MED/20 030211 gastroenterology & hepatology Female Complication business Prematurity Follow-Up Studies |
| Zdroj: | Journal of pediatric surgery, Vol. 53, no. 3, p. 483-488 (2018) |
| Popis: | Background and aims Anastomotic ulceration (AU) is a rare potential life-threatening complication that may occur after intestinal resection. The diagnosis is often delayed after a long-lasting history of refractory anemia. The pathogenesis remains unknown and there are no established therapies. The aim of the study was to analyze the medical history of children with short bowel syndrome (SBS) who were experiencing AU. Methods Records of SBS children were retrospectively reviewed. Demographics, baseline characteristics, presentation, diagnosis and treatment of AU cases were analyzed. Results Eight out of 114 children with SBS were identified as having AU. Mean gestational age was 32.5weeks. Underlying diseases were: 5 necrotising enterocolitis, 2 gastroschisis and 1 multiple intestinal atresia. The mean age at AU diagnosis was 6.5years (diagnosis delay of 35months). All but 2 patients had AU persistency after medical treatment. Endoscopic treatment (2 argon plasma coagulation; 1 platelet-rich fibrin instillation; 2 endoscopic hydrostatic dilations) was effective in 3 out of 5 children. Surgery was required in 3 patients. Conclusions Severe bowel ischemic injury, especially in preterm infant, could predispose to AU development. Medical treatment showed discouraging results. We firstly described that different endoscopic treatment could be attempted before resorting to further surgery. Level of Evidence: IV. |
| Databáze: | OpenAIRE |
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