Sheffield Children's Hospital, Western Bank, Sheffield.
Leicester Hospitals Trust, Leicester.
J Pediatr Gastroenterol Nutr. 2021 Sep 1;73(3):329-332. doi: 10.1097/MPG.0000000000003159.
Improvements in neonatal care and surgical advances, has led to an increased prevalence of children with small and large bowel anastomoses. Ulceration at the site of anastomosis is a rare, but well-recognised phenomenon, with no clearly understood pathogenesis. Paediatric case series have been reported but there remains no clear effective treatment strategy and there is limited experience with endoscopic techniques in their management. We report our tertiary centre experience of managing nine anastomotic ulcer patients, including endoscopic treatment with argon plasma coagulation and clips.Two patients with inflammatory bowel disease (IBD) responded to optimisation of medical therapy. In our non-IBD patients, those requiring a blood transfusion (n = 2) ultimately required surgery and those who did not require a blood transfusion responded to aminosalicylate treatment (n = 1) or endoscopic therapeutic techniques (n = 3).We conclude that endoscopic interventions can be an effective management strategy for anastomotic ulcers when a blood transfusion isn't required.
新生儿护理的改进和外科手术的进步,导致患有小肠和大肠吻合术的儿童患病率增加。吻合口溃疡是一种罕见但众所周知的现象,其发病机制尚不清楚。已经有儿科病例系列报道,但仍没有明确有效的治疗策略,并且在其管理中内镜技术的经验有限。我们报告了我们在三级中心管理 9 例吻合口溃疡患者的经验,包括使用氩等离子体凝固和夹闭进行内镜治疗。2 例炎症性肠病(IBD)患者对药物治疗的优化有反应。在我们的非 IBD 患者中,需要输血的患者(n=2)最终需要手术,而不需要输血的患者对氨基水杨酸治疗(n=1)或内镜治疗技术(n=3)有反应。我们的结论是,当不需要输血时,内镜干预可以是吻合口溃疡的有效治疗策略。