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Insights
Neonatal ileostomy management requires careful monitoring of stoma output and weight gain. Early high stoma output in infants can lead to suboptimal weight gain, impacting recovery.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
Background:
- Early medical management of neonatal ileostomy is not well-defined.
- Ileostomies in neonates present unique challenges for post-operative care.
Purpose of the Study:
- To define the early medical management of neonates undergoing ileostomy.
- To establish a template for expectant management based on post-operative progress.
Main Methods:
- Retrospective chart review of 16 infants who received an ileostomy between March 2010 and December 2011.
- Analysis of post-operative ileostomy progress, focusing on weight gain and stoma output.
Main Results:
- Infants showed no weight gain in the first 14 days post-ileostomy; median gain was 140 g/week by day 21.
- Median stoma output increased from 5 mL/kg/day (first 7 days) to 17.5-20 mL/kg/day.
- High stoma output (>20 mL/kg/day) in 10 infants was linked to suboptimal weight gain.
Conclusions:
- Weight gain in neonates with ileostomies is closely related to stoma output volume and consistency.
- A template for expectant management focusing on weight, stoma output, and complications is provided.
- Critical issues for neonatal ileostomy management include monitoring weight gain, stoma output, and potential complications.
Abstract:
The early post-ileostomy medical management of neonates is not clearly defined. A retrospective chart review of all infants who received an ileostomy March 2010-December 2011, identified the post-operative ileostomy progress of each infant. There were 16 cases of neonatal ileostomy during the study period. Over the first 14 postoperative days there was no weight gain. By 21 days the infants were gaining a median 140 g/week. The median stoma output was 5 mls/kg/dy during the first 7 days increasing to 17.5-20 mIs/kg/dy. Weight gain or weight loss was closely related to the consistency and volume of the stoma output. Ten infants had a hig stoma output > 20 mls/kg/dy (3 preterm, 7 term). This high stoma output was associated with sub-optimal weight gain. This study provides a template for the expectant management of newborn infants after an ileostomy. The critical issues are weight gain, stoma output and local and systemic complications.
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