J Korean Med Sci.  2012 Jun;27(6):701-703. 10.3346/jkms.2012.27.6.701.

Second Serial Transverse Enteroplasty Procedure in an Infant with Extreme Short Bowel Syndrome

• Oh JT
• Koh H
• Chang EY
• Chang HK
• Han SJ

• KMID: 1421626
• DOI: http://doi.org/10.3346/jkms.2012.27.6.701

Abstract

The serial transverse enteroplasty (STEP) procedure is a novel technique to lengthen and taper the bowel in patients with short bowel syndrome. The advantages of STEP include not only technical ease and simplicity, but also the ability to repeat the procedure. Herein, we report a case of extreme short bowel syndrome that was successfully treated by the second STEP procedure. A 3-day old newborn girl underwent STEP because of jejunal atresia with the small bowel length of 15 cm, but her bowel elongation was not enough to escape from short bowel syndrome. At the age of 6 months, she underwent a second STEP procedure. The bowel lengthening by the second STEP made her tolerable to enteral feeding with body weight gain and rescued her from short bowel syndrome. This case showed that second STEP is very helpful in treatment of extreme short bowel syndrome.

Keyword

Serial Transverse Enteroplasty (STEP); Short Bowel Syndrome; Infant

MeSH Terms

Digestive System Surgical Procedures
Female
Humans
Infant
Intestinal Atresia/surgery
Short Bowel Syndrome/radiography/*surgery

Figure

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  Fig. 1 High jejunal atresia. (A) Abdominal radiography showing distension of the proximal jejunum and (B) an intraoperative photograph showing the proximal jejunum and the distal ileum.

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  Fig. 2 Schematic illustration of the first STEP. (A) Preoperative and (B) postoperative bowel appearance and length.

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  Fig. 3 Schematic illustration of the second STEP and photographs of the small bowel. (A) Preoperative and (B) postoperative bowel appearance and length of the second STEP, and the appearance of the small bowel (C) before and (D) after the second STEP.

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