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Postobstructive enteropathy in infants with transient enterostomy: its consequences on the upper small intestinal

J P Cezard1, Y Aigrain, E Sonsino

  • 1Service de Gastroentérologie Pédiatrique, Hôpital Robert Debré, Paris, France.

Journal of Pediatric Surgery
|November 1, 1992
PubMed

Insights

Neonatal intestinal obstruction can cause feeding issues due to postobstructive enteropathy (POE). This study found POE is linked to abnormal small intestine motility, not mucosal changes, in infants.

Area of Science:

  • Neonatal surgery
  • Pediatric gastroenterology
  • Intestinal motility disorders

Background:

  • Neonatal intestinal obstruction can lead to severe refeeding problems, often attributed to postobstructive enteropathy (POE) in the segment above the obstruction.
  • POE is characterized by limited oral intake and increased ostomy effluent in infants.

Purpose of the Study:

  • To investigate the underlying causes of postobstructive enteropathy (POE) in neonates.
  • To compare the characteristics of infants with POE to those with a normal postoperative refeeding pattern.

Main Methods:

  • Compared 10 infants with POE to 8 controls with normal refeeding patterns after enterostomy.
  • Assessed histomorphometric mucosal appearance, digestive/absorptive capacity, effluent/duodenal flora, and intestinal peristalsis (barium and carmin transit times).

Main Results:

  • No significant differences were found in mucosal histomorphometry, digestive capacity, or absorptive capacity between POE patients and controls.
  • Effluent and duodenal floras were similar in both groups.
  • All POE patients exhibited abnormal small intestine peristalsis, indicated by altered transit times.

Conclusions:

  • Postobstructive enteropathy (POE) in neonates is likely caused by chronic abnormalities in small intestine motility above the obstruction, rather than mucosal changes.
  • POE can occur with various conditions causing neonatal intestinal obstruction, including but not limited to small bowel atresia.

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