Ileostomy Prolapse in Children with Intestinal Dysmotility
Eric A Sparks1,2, Cristine S Velazco1,2, Brenna S Fullerton1,2
1Center for Advanced Intestinal Rehabilitation, Boston Children's Hospital, Boston, MA, USA.
Gastroenterology Research and Practice
|October 28, 2017
Summary
Children with intestinal dysmotility face a high risk of ileostomy prolapse. Intestinal manometry may help identify at-risk patients before surgery.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Stoma care
Background:
- The link between intestinal motility and ileostomy prolapse is suspected but lacks objective evidence.
- Ileostomy prolapse is a significant complication in pediatric patients requiring ostomy surgery.
Purpose of the Study:
- To objectively evaluate the association between intestinal dysmotility and the occurrence of ileostomy prolapse in children.
- To determine if intestinal manometry findings correlate with clinical assessments of dysmotility and stoma prolapse risk.
Main Methods:
- Retrospective review of 163 pediatric patients with ileostomies.
- Patients classified by clinical diagnosis or suspicion of intestinal dysmotility.
- Analysis of intestinal manometry results (normal vs. abnormal) and correlation with stoma prolapse incidence.
Main Results:
- Clinical diagnosis of dysmotility and abnormal manometry were independently associated with stoma prolapse (p ≤ 0.001 and p = 0.024, respectively).
- Prolapse rates were higher in patients with dysmotility (42%) compared to suspected (34%) or unlikely dysmotility (24%).
- One-year prolapse-free survival was significantly lower in the dysmotility group (45%) versus others (p = 0.006).
Conclusions:
- Children with diagnosed intestinal dysmotility are at significantly increased risk for ileostomy prolapse.
- Intestinal manometry can aid in identifying pediatric patients with high prolapse risk preoperatively.
- Early identification and management strategies may be warranted for children with intestinal dysmotility and ileostomies.
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