Avoidance of stomas and delayed anastomosis for bowel necrosis: The 'clip and drop-back' technique

W. Glaze Vaughan, Jay L. Grosfeld, Karen West, L. R. Scherer, Enrique Villamizar, Frederick J. Rescorla

Research output: Contribution to journalArticle

58 Scopus citations

Abstract

Necrotizing enterocolitis (NEC) and midgut volvulus (MGV) often are associated with extensive bowel necrosis. These cases may require extensive enterectomy and the formation of high or multiple stomas, and frequently are complicated by short bowel syndrome, excessive fluid losses, fistulas, stenosis, and skin breakdown. This report describes a 'clip and drop-back' technique, followed by delayed anastomosis performed 48 to 72 hours later. The technique was successful in five severely ill infants (3 NEC, 2 MGV) with extensive necrosis, bowel perforation(s), and peritonitis, who required either a high stoma near the ligament of Treitz or multiple resections and enterostomies. This method removes obvious necrotic perforated bowel, controls contamination, avoids stomas (and their inherent complications in this age group), and preserves bowel length. All five babies survived. The technique is a useful addition to the pediatric surgeon's operative armamentarium in selective cases.

Original languageEnglish (US)
Pages (from-to)542-545
Number of pages4
JournalJournal of Pediatric Surgery
Volume31
Issue number4
DOIs
StatePublished - Apr 1996

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Keywords

  • Bowel ischemia
  • midgut vovlulus
  • necrotizing enterocolitis
  • neonatal peritonitis
  • second-look laparotomy

ASJC Scopus subject areas

  • Surgery

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