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Anastomotic Ulcers: Current Understanding of the Pathogenesis and Management

Shaunte McKay1, Valeria Cohran1, Lee M Bass2

  • 1Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave Box #65, Chicago, IL, 60611, USA.

Current Gastroenterology Reports
|June 11, 2023
PubMed

Insights

Anastomotic ulcers after intestinal surgery can cause severe anemia in children. Early diagnosis via endoscopy and treatment, including medication or surgery, are crucial for managing this condition.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Gastroenterology
  • Hematology

Background:

  • Anastomotic ulceration following intestinal resection is an under-recognized complication in pediatric patients.
  • This condition can lead to serious health issues, including refractory anemia.

Purpose of the Study:

  • To review the literature on pediatric anastomotic ulceration after intestinal resection.
  • To highlight the diagnostic and therapeutic approaches for this condition.

Main Methods:

  • Literature review of anastomotic ulceration in pediatric patients.
  • Discussion of diagnostic modalities such as upper and lower endoscopy and small intestinal endoscopy.
  • Overview of treatment strategies including medical and surgical options.

Main Results:

  • Anastomotic ulceration is a significant cause of refractory anemia in children post-intestinal resection.
  • Evaluation requires addressing micronutrient deficiencies and comprehensive endoscopic assessment.
  • Medical therapy involves anti-inflammatory agents and antibiotics for small intestinal bacterial overgrowth.
  • Surgical resection is considered for cases refractory to medical treatment.

Conclusions:

  • Pediatric anastomotic ulcers should be considered in cases of unexplained iron deficiency anemia after small bowel resection.
  • Prompt endoscopic evaluation is essential for diagnosis.
  • Surgical intervention may be necessary if medical management fails to resolve the ulcers.
Abstract

Keywords:
Anastomotic ulcerGI bleedingIntestinal failureShort bowel syndrome

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