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Updated: Aug 9, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Limited ileal resection in infancy: the long-term consequences
B W Davies1, G Abel, J W Puntis
1Department of Paediatric Surgery, Leeds Teaching Hospitals Trust and Centre for Bone and Body Composition Research, University of Leeds, England.
Insights
Children with limited ileal resection in infancy show good growth and nutrition. However, necrotizing enterocolitis (NEC) increases the risk of gallstones and vitamin B12 deficiency.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Nutritional Science
Background:
- Limited information exists on the long-term nutritional and metabolic effects of small (less than 50 cm) ileal resections in infants.
- Understanding these sequelae is crucial for developing appropriate follow-up strategies for affected children.
Purpose of the Study:
- To investigate the long-term nutritional, metabolic, and clinical outcomes in children who underwent limited ileal resection in infancy.
- To assess the prevalence of specific complications such as vitamin deficiencies, renal calculi, and cholelithiasis following ileal resection.
Main Methods:
- A cohort of children who had limited ileal resection for necrotizing enterocolitis (NEC) or intussusception between 1984 and 1992 were evaluated.
- Assessments included clinical examination, anthropometry, hematologic and biochemical tests, ultrasound, and bone mineral density measurements.
- A control group of children with neonatal NEC who did not undergo surgery was also included for comparison.
Main Results:
- Twenty-four children (17 NEC, 7 intussusception) with a median age of 7.4 years participated.
- Growth parameters (height, weight, BMI) were generally within normal percentiles (25th-50th).
- One child had asymptomatic vitamin B12 deficiency, three had low vitamin A, and four (24%) developed cholelithiasis, all with prior NEC. Trace element levels were occasionally low in both groups.
Conclusions:
- Limited ileal resection in infancy is associated with preserved growth and nutritional status.
- Necrotizing enterocolitis (NEC) as a reason for limited ileal resection is linked to a high prevalence of cholelithiasis (gallstones).
- A risk of vitamin B12 deficiency exists after limited ileal resection, necessitating careful long-term follow-up planning.
Background/Purpose:
The longer-term sequelae of short bowel syndrome in infancy are reasonably well documented, but little is known about the long-term nutritional and metabolic effects of limited (less than 50 cm) ileal resection. This makes it difficult to formulate a rational follow-up policy in such children.
Methods:
All children who underwent limited ileal resection for either necrotizing enterocolitis (NEC) or intussusception at our institution between 1984 and 1992 were invited to attend a detailed clinical, anthropometric, hematologic, and biochemical assessment, together with a biliary and renal ultrasound scan and measurement of bone mineral density.
Results:
Twenty-four children (NEC, 17; intussusception, 7) of median age 7.4 years (range, 5.5 to 13.7 years) agreed to participate. Nine previously had undergone an isolated ileal resection, and 15 also had had variable lengths of colon removed. The length of resected ileum ranged from 3 to 44 cm, with a median of 10 cm. Seven control subjects in whom neonatal NEC developed but recovered without surgery were also evaluated. Median height, weight, and body mass index after ileal resection were between the 25th and 50th percentiles; no child was stunted or wasted. After ileal resection, one boy was found to have asymptomatic vitamin B12 deficiency, and three children had low plasma concentrations of vitamin A. Hematologic and biochemical parameters were otherwise normal apart from a few marginally low trace element levels in both subjects and controls. No renal calculi were detected, and bone mineral density measurements were normal in all except one child. Four children had cholelithiasis, all of whom had previously undergone limited ileal resection for NEC (two isolated, two ileocolic). Thus, the prevalence of cholelithasis after limited ileal resection for NEC was 24% at a median age of 7.0 years.
Conclusions:
Growth and nutritional status are well preserved after limited ileal resection in infancy. Limited ileal resection for NEC is associated with a subsequent high prevalence of cholelithiasis and a risk of vitamin B12 deficiency. These findings are important when planning strategies for long-term follow-up.
