[Continuous extracorporeal stool transport (CEST) in a preterm infant with proximal ileostomy: report of a case].
Children with ileostomy can develop short bowel syndrome (SBS), characterized by malabsorption of nutrients and consequent malnutrition. Continuous extracorporeal stool transport (CEST) consists of collecting and transporting the intestinal effluent drained from the proximal stoma to the portion of the distal intestine. Thus, intestinal flux can be maintained, while digestion and absorption approximate real physiology until defecation. We describe the case of a preterm newborn who suffered from necrotizing enterocolitis and who underwent resection of the small intestine and implantation of four stomas. CEST was applied, allowing early reduction of total enteral nutrition and its subsequent withdrawal. This in turn allowed the reduction of those complications associated to the continous use of this therapy (risk of infection and hepatobiliary alterations) and permited keeping the distal intestine in optimal conditions until reconstructive surgery could be performed. Our experience demonstrates that CEST is a safe and relatively simple technique with good results that allows restoration of intestinal homeostasis in neonates with SBS.
Unidad de Neonatología y UCIP, Corporación Sanitaria Parc Taulí, Sabadell, Barcelona, España. mtrumi@hotmail.com
Mari Trini
MT
Jiménez-Rumí
Marisol
M
Jiménez-Molina
Marta
M
Tamame-San Antonio
Carme
C
Albert-Mallafré
Noelia
N
Cotorruelo-da Costa
Eva
E
Escardó-Piñol
Patricia
P
Casanova-Fernández
D020345:Enterocolitis, Necrotizing / Q000601:surgery*; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000601:surgery*; D008297:Male