Alternative technique to save ischemic bowel segment in management of neonatal short bowel syndrome: A case report.

Content Provider	Europe PMC
Author	Geng, Lei Zhou, Lei Ding, Guo-Jian Xu, Xiao-Liang Wu, Yu-Mei Liu, Ji-Jun Fu, Ting-Liang
Copyright Year	2019
Abstract	BACKGROUNDCongenital short bowel syndrome (SBS) associated with malrotation, gut volvulus and jejuno-ileal atresia is a very rare condition. It is a severe challenge for surgeons to preserve residual ischemic bowel segment in the management of short bowel syndrome,especially in neonates.CASE SUMMARYWe report a newborn baby with gut malrotation associated with jejuno-ileal atresia, congenital SBS and jejunal volvulus. Hematemesis and abdominal distention were noted. At laparotomy, malrotation associated with jejuno-ileal atresia, congenital SBS and jenunal volvulus was confirmed. The total length of the small bowel was 63 cm with proximal jejunal bowel segment measuring 38 cm, including 18 cm necrotic segment below the Treitz’s ligament and 20 cm severe ischemic segment. The distal part of the small bowel was 25 cm in length and only about 0.8 cm in diameter. Ladd’s procedure, necrotic segment resection and end-to-back duodeno-ileal anastomosis were performed. The residual severe ischemic jejunum was preserved with single proximal stoma and distal end closure. Three months later, to restore the continuity of the isolated gut segment, end-to-end duodeno-jejunal and jejuno-ileal anastomosis was performed. The entire functional small bowel length increased to 80 cm. Intravenous fluid therapy and parenteral nutrition were discontinued on the 10th day postoperatively. Twelve months later, her body weight was 9.5 kg.CONCLUSIONIsolation of severe ischemic bowel segment and staged anastomosis to restore the gut continuity for infants with SBS are safe and feasible.
Volume Number	7
PubMed Central reference number	PMC6819291
Issue Number	20
PubMed reference number	31667191
Journal	World Journal of Clinical Cases
e-ISSN	23078960
DOI	10.12998/wjcc.v7.i20.3353
Language	English
Publisher	Baishideng Publishing Group Inc
Publisher Date	2019-10-01
Access Restriction	Open
Rights License	This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Subject Keyword	Ischemic bowel segment Short bowel syndrome Bowel isolation technique Staged salvaging procedure Case report
Content Type	Text
Resource Type	Article
Subject	Medicine