Repeat STEP procedure to establish enteral nutrition in an infant with short bowel syndrome.
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.
Morikawa
Nobuyuki
N
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
Kuroda
Tatsuo
T
Kitano
Yoshihiro
Y
Tanaka
Hideaki
H
Takayasu
Hajime
H
Fujino
Akihiro
A
Shibata
Yumiko
Y
Tanemura
Hiroko
H
Muto
Mitsuru
M
Honna
Toshiro
T
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*
J Am Coll Surg. 2007 Mar;204(3):365-71
17324769
Transplantation. 2008 May 15;85(9):1294-9
18475187
J Pediatr Surg. 2007 Nov;42(11):1804-10
18022427
J Pediatr Surg. 2003 Jun;38(6):881-5
12778385
Hepatology. 1998 Nov;28(5):1289-99
9794914
J Pediatr Surg. 1980 Apr;15(2):145-51
7373489
J Pediatr Surg. 2009 Jan;44(1):229-35; discussion 235
19159748
Ann Surg. 2006 Feb;243(2):223-8
16432355
Hepatology. 1998 Jan;27(1):108-15
9425925
J Pediatr Surg. 2005 Jun;40(6):1019-23; discussion 1023-4
15991189
Eur J Pediatr Surg. 1999 Aug;9(4):260-2
10532272
J Pediatr Surg. 2006 Jan;41(1):113-9; discussion 113-9
16410119
J R Soc Med. 1997 Aug;90(8):429-32
9306995
J Pediatr Surg. 2003 Mar;38(3):425-9
12632361
J Pediatr Surg. 2006 Dec;41(12):1951-6
17161180
J Pediatr Gastroenterol Nutr. 2008 Aug;47 Suppl 1:S33-6
18667916
J Pediatr Surg. 2007 May;42(5):819-22
17502191
J Pediatr Surg. 2001 Jan;36(1):178-83
11150461
Gastroenterology. 2006 Feb;130(2 Suppl 1):S138-46
16473062
Ann Surg. 2005 Sep;242(3):403-9; discussion 409-12
16135926