Document Detail

Mucous fistula refeeding in premature neonates with enterostomies.
MedLine Citation:
PMID:  15187779     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Premature neonates with short bowel syndrome often have diverting enterostomies and distal mucous fistulae. The authors reviewed their experience in 12 premature neonates in whom proximal bowel contents were re-fed into the mucous fistula. METHODS: We reviewed the records of 12 premature neonates who presented with acute abdomen and who underwent intestinal resection with formation of diverting enterostomy and mucous fistula between July 1999 and December 2002. All received parenteral nutrition. Refeeding of enterostomy contents into the distal mucous fistula was commenced after patency of the distal intestine was confirmed by radiologic examination. Demographic data, body weight and clinical outcomes were recorded. RESULTS: Median gestational age was 31 weeks and mean birth weight was 1.59 kg. Diagnoses included necrotizing enterocolitis (n = 6), meconium ileus-like conditions (n = 2), ileal atresia (n = 2), malrotation with volvulus (n = 1) and focal intestinal perforation (n = 1). Refeeding was successfully established in all patients with no complications. The mean duration of refeeding was 63.5 days. All patients achieved good weight gain after refeeding (18.9 +/- 2.9 g/d) with a reduction of parenteral nutrition requirements. All enterostomies were subsequently closed. Four patients died of unrelated causes after reanastomosis and the remaining eight were discharged. CONCLUSIONS: Mucous fistula refeeding is safe in premature neonates with enterostomies. It can prevent disuse atrophy in the distal loop and facilitate subsequent reanastomosis. Furthermore, the increased absorptive function provided by the small bowel incorporated in the mucous fistula can reduce the requirement for total parenteral nutrition.
Kenneth K Y Wong; Laurence C L Lan; Steve C L Lin; Audrey W S Chan; Paul K H Tam
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  39     ISSN:  0277-2116     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-09     Completed Date:  2005-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  43-5     Citation Subset:  IM    
Division of Paediatric Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
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MeSH Terms
Enterostomy / methods*
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / surgery*,  therapy
Intestinal Fistula / etiology,  therapy*
Parenteral Nutrition*
Retrospective Studies
Short Bowel Syndrome / surgery*,  therapy
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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