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Gastrointestinal myoelectric activity in a child with gastroschisis and ileal atresia
G Cheng1, M R Langham, C A Sninsky
1Department of Surgery, University of Florida, College of Medicine, USA.
Insights
This study monitored gastric and small bowel myoelectric activity in a child with gastroschisis and ileal atresia. Myoelectric recordings provided insights into the child's gastrointestinal motility issues.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Biomedical Engineering
Background:
- Gastroschisis often presents with intestinal atresia and impaired gastrointestinal function.
- Children with complex gastroschisis and ileal atresia may experience prolonged feeding intolerance.
- Assessing gastrointestinal motility is crucial for managing these complex cases.
Observation:
- Gastric and small bowel myoelectric activity was monitored in a child with gastroschisis and ileal atresia.
- Persistent gastric dysrhythmias and abnormal small bowel motility were observed post-repair.
- The child's gut converted to a fed myoelectric pattern with enteral tube feedings.
Findings:
- Implanted serosal electrodes provided safe and feasible myoelectric recordings in a pediatric patient.
- Myoelectric recordings revealed persistent gastric dysrhythmias and retrograde activity in the small bowel.
- A shift to a fed myoelectric pattern correlated with improved tolerance of tube feedings.
Implications:
- Myoelectric recordings may offer valuable insights into underlying gastrointestinal motility disorders in children.
- This technique shows promise for guiding clinical management in complex pediatric surgical cases.
- Further research is needed to establish the definitive clinical role of myoelectric recordings in pediatric motility disorders.
Abstract:
Gastroschisis is frequently associated with intestinal atresia and alterations in gastrointestinal function. The authors studied gastric and small bowel myoelectric activity in a child who had a complex course and prolonged inability to tolerate oral intake after staged repair of gastroschisis and an associated ileal atresia. The child remained unable to tolerate oral intake after repair of the atresia and was reexplored 3 months later to rule out a partial small bowel obstruction, with simultaneous placement of serosal electrodes on the stomach and proximal small bowel. Persistent gastric dysrhythmias were observed postoperatively, and the child was unable to tolerate gastrostomy tube feedings. Abnormalities were also seen in small bowel motility, including retrograde propagation of activity fronts of the migrating myoelectric complex. However, the intestine converted to a fed myoelectric pattern with tube feedings, and the child was subsequently able to tolerate feedings via a tube placed directly into the small bowel. The authors conclude that myoelectric recordings via implanted electrodes are safe and feasible in children, and may give information regarding underlying motility alterations. The ultimate clinical role of myoelectric recordings in treating children with suspected motility disorders will require further study.