Staple line ulcers: a cause of chronic GI bleeding following STEP procedure.

Abstract:

:Intestinal failure (IF) results from a critical reduction in the functional intestinal mass resulting in dependence on total parenteral nutrition (TPN) for growth and survival. Short bowel syndrome (SBS) is the most common cause of intestinal failure in pediatrics. Following resection, the small bowel undergoes adaptation, a process wherein the bowel elongates and dilates in order to increase intestinal absorptive capacity. Small bowel dilatation can lead to dysmotility and small bowel bacterial overgrowth which may further enhance feeding intolerance. Bowel lengthening procedures are beneficial when there is significant dilatation of the small bowel and subsequent inability to advance enteral feeds. We describe a patient with intestine failure and short bowel syndrome due to gastroschisis who, presented with anemia and occult gastrointestinal bleeding, following Serial Transverse Enteroplasty procedure (STEP). Video capsule endoscopy (VCE) revealed multiple ulcerations at surgical staple sites throughout the distal 2/3 of the remaining small intestine which were the likely source of intestinal blood loss.

journal_name

J Pediatr Surg

authors

Gibbons TE,Casteel HB,Vaughan JF,Dassinger MS

doi

10.1016/j.jpedsurg.2013.04.011

subject

Has Abstract

pub_date

2013-06-01 00:00:00

pages

E1-3

issue

6

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(13)00384-9

journal_volume

48

pub_type

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