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Updated: Mar 22, 2026
Neonatal Pial Surface Electroporation
Published on: May 7, 2014
Neonatal Serial Transverse Enteroplasty (STEP): Case Report
P A Lobos1, S E M Calello2, V B Busoni3
1Pediatric Surgery Division, Caba, Argentina; Center for Intestinal Transplantation and Rehabilitation, Caba, Argentina; Department of Pediatrics, Caba, Argentina; Department of Surgery, Caba, Argentina; Hospital Italiano de Buenos Aires, Caba, Buenos Aires, Argentina.
Insights
Serial transverse enteroplasty effectively treats complex gastroschisis with intestinal atresia. This surgical technique preserves bowel mucosa and improves motility, offering an alternative to bowel resection for infants with short bowel syndrome.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Neonatal Care
Background:
- Gastroschisis, a common congenital abdominal wall defect, can lead to short bowel syndrome when complicated by intestinal atresia.
- Complex gastroschisis is a primary cause of short bowel syndrome in neonates.
Observation:
- A case report details the surgical management of a newborn with type IVa intestinal atresia and colonic stenosis following primary gastroschisis repair.
- The procedure involved tailoring dilated jejunum using serial transverse enteroplasty and performing an end-to-end jejunal-ileal anastomosis.
Findings:
- The serial transverse enteroplasty procedure successfully tailored the jejunal loop, preserving absorptive mucosa and improving bowel motility.
- Postoperative management included vacuum-assisted therapy for an enterocutaneous fistula, with successful transition to full enteral feedings within 30 days.
Implications:
- This approach offers an aggressive surgical strategy to preserve bowel mucosal surface area in infants with intestinal atresia and dilated bowel.
- Serial transverse enteroplasty is a viable alternative to bowel resection techniques for managing short bowel syndrome in neonates.
Case Report:
Gastroschisis is the most frequent congenital abdominal wall defect. When associated with intestinal atresia (complex gastroschisis), short bowel syndrome may occur. Complicated gastroschisis is the most frequent cause of short bowel syndrome in our series. The serial transverse enteroplasty procedure has been used to lengthen the bowel and achieve intestinal rehabilitation in patients with dilated gut. The use of this technique in the newborn period, for tailoring the bowel while preserving absorptive mucosa, has been recently described. We present a video showing the surgical treatment of an intestinal obstruction produced by a complex intestinal atresia in a newborn baby in whom a primary closure of a gastroschisis had been done at birth. During laparotomy at the 21st day of life, a type IVa intestinal atresia was found, associated with a colonic stenosis. Proximal dilated jejunum was tailored with a serial transverse enteroplasty procedure, as shown in the video. End-to-end jejunal-ileal anastomosis was performed. Postoperative entero-cutaneous fistula occurred and was treated with vacuum-assisted therapy. Enteral feedings were initiated at 15 days after surgery. Parenteral nutrition was withdrawn at 30 days. After 16 months follow-up, actual weight was 8.7 kg (percentile 10% to 25%). The patient remained on full enteral feedings.
Conclusions:
In cases of intestinal atresia, short bowel syndrome, and proximal dilated bowel, we propose an aggressive surgical approach to preserve bowel mucosal surface while tailoring the jejunal loop to improve motility. The serial transverse enteroplasty procedure is an acceptable alternative to tailoring methods that resect a segment of the bowel wall.
