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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.
Journal of Pediatric Surgery
|May 11, 1999
Summary
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.