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Brown bowel syndrome: a late complication of intestinal atresia
Insights
Children with prior jejunal atresia repair developed dilated small intestine, presenting as "brown bowel" due to muscle changes and vitamin E deficiency. Treatment involved surgical correction and nutritional support.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Nutritional Science
Background:
- Jejunal atresia is a congenital condition requiring neonatal surgical correction.
- Post-correction complications can include long-term small intestine issues.
- Nutritional deficiencies, particularly vitamin E, can arise from gastrointestinal malabsorption.
Observation:
- Two pediatric patients, previously treated for jejunal atresia, presented with massive proximal small intestine dilation.
- This dilation was characterized by circular muscular hypertrophy and lipofuscin deposition, leading to a "brown bowel" appearance.
- The condition was clinically associated with significant malnutrition and documented vitamin E deficiency.
Findings:
- The "brown bowel" finding in these cases is linked to muscular changes and pigment accumulation in the dilated jejunum.
- Malnutrition and vitamin E deficiency were key comorbidities, suggesting impaired nutrient absorption.
- Surgical intervention included limited resection, extensive tapering of the dilated segment, and end-to-end reanastomosis.
Implications:
- This case highlights a rare but serious long-term complication of jejunal atresia repair.
- Early recognition and management of "brown bowel" syndrome are crucial for preventing malnutrition and improving outcomes.
- Long-term nutritional support and vitamin E supplementation are essential components of patient care.
Abstract:
Two children, aged 11 years, who originally had jejunal atresia corrected in the neonatal period, developed massive dilatation of the proximal small intestine. This resulted in circular muscular hypertrophy with lipofuscin deposits giving the typical appearance of "brown bowel." The condition was associated with malnutrition and vitamin E deficiency. Because of relatively short bowel, the condition was treated by limited resection and extensive tapering of the dilated segment, end-to-end reanastomosis, vitamin E supplementation, and intensive nutritional support.