Congenital intestinal anomalies, neonatal short bowel syndrome, and prenatal/neonatal counseling

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Germana Casaccia1, Alessandro Trucchi, Ioannis Spirydakis

  • 1Department of Surgical and Medical Neonatology, Neonatal Surgery Unit, Bambino Gesù Pediatric Hospital, 00165 Rome, Italy. germanacasaccia@hotmail.com

Journal of Pediatric Surgery
|March 29, 2006
PubMed

Insights

Congenital intestinal anomalies (CIA) detected prenatally are frequently linked to short bowel syndrome (SBS), leading to increased infant morbidity and longer hospital stays.

Area of Science:

  • Pediatric Surgery
  • Neonatology
  • Gastroenterology

Background:

  • Short bowel syndrome (SBS) is a severe malabsorption condition resulting from intestinal loss.
  • Congenital intestinal anomalies (CIA), including jejunoileal atresia and fetal volvulus, are primary causes of SBS in neonates.
  • Prenatal ultrasound can detect specific CIA that may lead to SBS.

Purpose of the Study:

  • To determine the frequency of SBS in infants with CIA.
  • To evaluate the morbidity associated with SBS in the CIA population during their initial hospitalization.

Main Methods:

  • Retrospective review of CIA cases treated between 1997 and 2003.
  • Correlation of prenatal ultrasound findings with SBS development.
  • Statistical analysis (t-tests, chi-squared) of epidemiological data, growth, sepsis, liver disease, catheter complications, motor delay, and hospital stay in CIA with and without SBS.

Main Results:

  • SBS developed in 43% of CIA cases, with the highest incidence in volvulus (83%) and none in complicated meconium ileus.
  • A strong correlation between SBS and isolated dilated bowel (58%) was observed in prenatal diagnoses.
  • Neonates with SBS had lower birth weight, gestational age, and growth at discharge, but higher rates of sepsis, motor delay, and prolonged hospital stays.

Conclusions:

  • Prenatally detectable CIA are a significant cause of SBS in neonates.
  • SBS is associated with substantially higher morbidity in infants with CIA.
  • Prenatal counseling should emphasize the strong link between CIA and SBS and its associated morbidity.
Abstract

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