title: Repeat STEP procedure to establish enteral nutrition in an infant with short bowel syndrome.
abstract: The serial transverse enteroplasty (STEP) procedure is a safe and successful way to lengthen the small bowel in patients with short bowel syndrome. However, postoperative dilatation of the intestine may occur, which induces bacterial overgrowth and malabsorption leading to liver failure. We describe the case of an infant boy with short bowel syndrome caused by jejunal atresia requiring the STEP procedure twice. The first STEP improved the liver function, and the second STEP allowed 80% of the total calorie intake to be tolerated enterally. One should not hesitate to perform a second STEP if after the initial bowel lengthening procedure the patient develops small bowel dilatation that interferes with enteral nutrition.
authors.affiliation: Division of General Surgery, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, 157-8535, Japan. morikawa-n@ncchd.go.jp
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Morikawa
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kuroda
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kitano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Hajime
authors.initials: H
authors.lastname: Takayasu
authors.forename: Akihiro
authors.initials: A
authors.lastname: Fujino
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Shibata
authors.forename: Hiroko
authors.initials: H
authors.lastname: Tanemura
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Muto
authors.forename: Toshiro
authors.initials: T
authors.lastname: Honna
mesh_terms: D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D004108:Dilatation, Pathologic / Q000209:etiology / Q000601:surgery; D004750:Enteral Nutrition; D006801:Humans; D007231:Infant, Newborn; D007421:Intestine, Small / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012778:Short Bowel Syndrome / Q000601:surgery*
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