Intestinal stenting in preterm, very-low-birth-weight infants with necrotizing enterocolitis and multiple perforations.
We present 2 cases of necrotizing enterocolitis with multiple intestinal perforations or areas of segmental bowel necrosis in preterm, very-low-birth-weight infants. We reviewed their charts and researched the related literature. We used SILASTIC (Silmag, Argentina) intestinal stents to avoid multiple formal bowel anastomosis or stomas and longer resections, and to reduce operative time. In the first case, we externalized the stent through the first and last perforation; and in the second, through a proximal jejunostomy and the orifice left after an appendectomy. This method was useful in avoiding short bowel syndrome in both infants, and they were discharged successfully. They are currently 31/2 and 2 years old, respectively, eating without any restriction and with mild developmental delays. Treatment of preterm infants with multiple bowel perforations or areas of bowel necrosis requires a maximal effort to preserve as much intestinal length as possible. Use of the SILASTIC stent technique provides a good treatment variant in selected cases to preserve bowel length, reduce operative time, and avoid short bowel syndrome.
Blejter
Javier
J
Pediatric Surgery Service, Pedro de Elizalde Hospital, Buenos Aires, Argentina. javiblejter@yahoo.com.ar
Millan
Fernando
F
Gimenez
Javier
J
Martinez
Antonio
A
Giambini
Daniel
D
D020345:Enterocolitis, Necrotizing / Q000601:surgery*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007416:Intestinal Perforation / Q000601:surgery*; D007422:Intestines / Q000601:surgery*; D008297:Male; D015607:Stents