Repeat STEP procedure to establish enteral nutrition in an infant with short bowel syndrome

The serial transverse enteroplasty (STEP) procedure is a safe and successful way to lengthen the small bowel in patients with short bowel syndrome. However, postoperative dilatation of the intestine may occur, which induces bacterial overgrowth and malabsorption leading to liver failure. We describe...

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Bibliographic Details
Published in:Pediatric surgery international 2009-11, Vol.25 (11), p.1007-1011
Main Authors: Morikawa, Nobuyuki, Kuroda, Tatsuo, Kitano, Yoshihiro, Tanaka, Hideaki, Takayasu, Hajime, Fujino, Akihiro, Shibata, Yumiko, Tanemura, Hiroko, Muto, Mitsuru, Honna, Toshiro
Format: Article
Language:English
Subjects:
Case Report
Digestive System Surgical Procedures - adverse effects
Digestive System Surgical Procedures - methods
Dilatation, Pathologic - etiology
Dilatation, Pathologic - surgery
Enteral Nutrition
Humans
Infant, Newborn
Intestine, Small - surgery
Male
Medicine
Medicine & Public Health
Pediatric Surgery
Pediatrics
Postoperative Complications - etiology
Postoperative Complications - surgery
Reoperation
Short Bowel Syndrome - surgery
Surgery
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Summary:The serial transverse enteroplasty (STEP) procedure is a safe and successful way to lengthen the small bowel in patients with short bowel syndrome. However, postoperative dilatation of the intestine may occur, which induces bacterial overgrowth and malabsorption leading to liver failure. We describe the case of an infant boy with short bowel syndrome caused by jejunal atresia requiring the STEP procedure twice. The first STEP improved the liver function, and the second STEP allowed 80% of the total calorie intake to be tolerated enterally. One should not hesitate to perform a second STEP if after the initial bowel lengthening procedure the patient develops small bowel dilatation that interferes with enteral nutrition.
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-009-2456-1