Radiologic Image-Guided Tube Stoma Insertion in Neonatal Short Bowel Syndrome: First Case Report in the Literature

• Published in: Journal of laparoendoscopic & advanced surgical techniques. Part A Vol. 29; no. 10; p. 1330
• Main Authors: Elifranji, Mohammed, Robinson, Ashley, Mammoo, Saleem, Zarroug, Abdalla, Khalil, Basem A
• Format: Journal Article
• Language: English
• Published: United States 01.10.2019
• Subjects: Child; Digestive System Surgical Procedures - methods; Female; Humans; Infant, Newborn; Intestines - surgery; Short Bowel Syndrome - surgery; Surgery, Computer-Assisted - methods; Surgical Stomas; Tissue Expansion - methods; bowel expansion; tube stoma; short bowel; minimal invasive
• ISSN: 1557-9034
• DOI: 10.1089/lap.2019.0048

The management of neonatal short bowel syndrome can be challenging, and it is critical that these babies are managed in a multidisciplinary team setting with specialists who are experienced in the complex management of these children. One of the surgical strategies, initially published by the Bianchi team in Manchester, UK, is controlled tissue expansion program (CTE) which is done via the insertion of catheters into the proximal and distal bowel in the form of tube stomas. The clamping of the proximal tube allows for an increase in length and circumferential diameter of the proximal bowel for a period of time, whilst the distal tube stoma allows for easy refeeding of proximal bowel contents into the distal bowel. CTE is associated with the risk of dislodgement and exposing patients to further surgical procedures with the risk of losing more bowel length. This article describes a new method in the management of such a complication through a less invasive approach of an image-guided procedure by interventional radiologists. Radiologically guided tube stoma reinsertion in a child with ultrashort bowel syndrome is a promising technique and should be considered in a CTE program in the management of short bowel syndrome.