The STEP procedure in an adult patient with short bowel syndrome: a case report

The serial transverse enteroplasty procedure is an autologous intestinal reconstruction technique defined and used originally in pediatric patients. In this paper, we describe the serial transverse enteroplasty method and outcomes in an adult male patient who underwent extensive bowel resection after mesenteric artery embolism and later developed short bowel syndrome. He was diagnosed with mesenteric artery embolism and related extensive bowel necrosis and underwent extensive bowel resection including the right colon. The remaining 60 cm was diverted to the proximal jejunum as the end stoma. He received total parenteral nutrition for five months and underwent serial transverse enteroplasty in the fifth postoperative month. The jejunum of 60 cm in length was elongated to 100 cm using the serial transverse enteroplasty method. The patient was 80% total parenteral nutrition-dependent preoperatively, but became totally total parenteral nutrition-free in the third month after the procedure, and nutrition needs could be met enterally. The serial transverse enteroplasty procedure can be used as an effective and reliable autologous intestinal reconstruction method in adult patients with intestinal insufficiency due to short bowel syndrome, just as in pediatric patients.