title: [Small bowel overgrowth: a frequent complication after abdominal surgery in newborns].
abstract: OBJECTIVE
  Surgery for congenital or acquired gastroenterological disorders, and particularly that associated with short bowel, is not infrequently complicated by Small Bowel Bacterial Over growth (SBBO). Aim of this study is to evaluate the clinical course of children undergoing bowel surgery in the newborn period, assessing the development of SBBO and the response to intensive treatment with a "bowel cocktail" of gentamycin, metronidazole and cholestyramine.
  
  
  METHODS
  17 children with various conditions were studied clinically and by Breath Hydrogen Test (fasting and after glucose). 14 children underwent more than one procedure. All children were treated with overall "bowel cocktail" of gentamycin, metronidazole and cholestyramine.
  
  
  RESULTS
  5 children recovered after one course of treatment and 11 children relapsed at least once and required further courses of therapy. One child died from TPN related liver failure and another following a liver and small bowel transplant for short bowel syndrome. A third child required total intestinal tube splinting according to Sauer and another one required a tapering of the preatretic enlarged jejunal loop.
  
  
  CONCLUSIONS
  Our study suggests that children undergoing bowel surgery in the neonatal period and those having more than one procedure are at greater risk of developing small bowel bacterial overgrowth postoperatively. Interestingly, loss of the ileocecal valve was not associated with an increased risk of bacterial overgrowth.
authors.affiliation: Istituti Clinici di Perfezionamento, Milano Ospedale del Bambini V. Buzzi, UO di Chirurgia Pediatrica, UO di Pediatria. luciano.maestri@tin.it
authors.forename: L
authors.initials: L
authors.lastname: Maestri
authors.forename: G
authors.initials: G
authors.lastname: Fava
authors.forename: M
authors.initials: M
authors.lastname: Fontana
authors.forename: E
authors.initials: E
authors.lastname: Leva
authors.forename: G
authors.initials: G
authors.lastname: Lista
authors.forename: S
authors.initials: S
authors.lastname: Paccagnini
authors.forename: A
authors.initials: A
authors.lastname: Pansini
authors.forename: G
authors.initials: G
authors.lastname: Selvaggio
authors.forename: M
authors.initials: M
authors.lastname: Torricelli
authors.forename: G
authors.initials: G
authors.lastname: Zuin
authors.forename: L
authors.initials: L
authors.lastname: Pansini
authors.forename: A
authors.initials: A
authors.lastname: Bianchi
mesh_terms: D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000209:etiology / Q000473:pathology / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications