Concomitant involvement of the small intestine and the distal esophagus in an infant with massive necrotizing enterocolitis.
Necrotizing enterocolitis is a disease of the newborn that may involve the small intestine and/or the colon, and the stomach. To our knowledge, massive necrosis of the small intestine with concomitant involvement of the esophagus has never been reported. A case of a 6-month-old boy with necrotizing enterocolitis and pan-necrosis of the small intestine, cecum, and the lower third of the esophagus is presented. After 70 days of treatment, intestinal transit was established by an anastomosis between the first centimeter of jejunum and the ascending colon. Finally, esophageal transit was established by a total gastric transposition with cervical esophagogastric anastomosis. The patient was maintained under total parenteral nutrition, and after 19 months he developed fulminant hepatic failure due to parenteral nutrition; he then underwent combined liver and small bowel transplantation. After 2 months, the patient died due to undefined neurologic complications, probably related to infection or immunosuppressive therapy.
Pediatric Intensive Care Unit, Albert Einstein Jewich Hospital, Pediatric Surgery Division, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil. uenis@usp.br
Uenis
U
Tannuri
Virginia Antelmi
VA
Gomes
Eduardo Juan
EJ
Troster
D000714:Anastomosis, Surgical; D020345:Enterocolitis, Necrotizing / Q000150:complications / Q000473:pathology* / Q000601:surgery; D004947:Esophagus / Q000473:pathology*; D017809:Fatal Outcome; D006801:Humans; D007223:Infant; D007421:Intestine, Small / Q000473:pathology* / Q000637:transplantation; D017114:Liver Failure, Acute / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D009336:Necrosis