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Gastrointestinal Complications: Necrotizing Enterocolitis, Malrotation, and Protein Losing Enteropathy

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Critical Care of Children with Heart Disease

Abstract

Necrotizing enterocolitis (NEC) is an acute inflammatory disease with a multifactorial and controversial pathogenesis. NEC is a disease of newborns that is characterized by variable damage to the intestinal tract ranging from mucosal injury to full-thickness necrosis and perforation. The terminal ileum and proximal ascending colon are the most common sites of NEC. The disease may involve a single isolated lesion, multiple discontinuous areas or in rare instances pan-necrosis.

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References

  1. Stapleton GE, Eble BK, Dickerson HA, et al. Mesenteric oxygen desaturation in an infant with congenital heart disease and necrotizing enterocolitis. Tex Heart Inst J. 2007;34:442-444.

    PubMed  Google Scholar 

  2. Ostlie DJ, Spilde TL, St Peter SD, et al. Necrotizing enterocolitis in full-term infants. J Pediatr Surg. 2003;38:1039-1042.

    Article  PubMed  Google Scholar 

  3. McElhinney DB, Hedrick HL, Bush DM, et al. Necrotizing enterocolitis in neonates with congenital heart disease: risk factors and outcomes. Pediatrics. 2000;106:1080-1087.

    Article  PubMed  CAS  Google Scholar 

  4. Booker PD, Romer H, Franks R. Gut mucosal perfusion in neonates undergoing cardiopulmonary bypass. Br J Anaesth. 1996;77:597-602.

    Article  PubMed  CAS  Google Scholar 

  5. Lerberg DB, Hardesty PL, Siewers RD, et al. Coarctation of the aorta in infants and children: 25 years of experience. Ann Thorac Surg. 1982;33:159-170.

    Article  PubMed  CAS  Google Scholar 

  6. O’Donovan DJ, Baetiong A, Adams K, et al. Necrotizing enterocolitis and gastrointestinal complications after indomethacin therapy and surgical ligation in premature infants with patent ductus arteriosus. J Perinatol. 2003;23:286-290.

    Article  PubMed  Google Scholar 

  7. Epelman M, Daneman A, Navarro OM, et al. Necrotizing enterocolitis: review of state of the art imaging findings with pathologic correlation. Radiographics. 2007;27:285-305.

    Article  PubMed  Google Scholar 

  8. Gollin G, Abarbenell A, Baerg JE, et al. Peritoneal drainage as definitive management of intestinal perforation in extremely low-birth-weight infants. J Pediatr Surg. 2003;38:1814-1817.

    Article  PubMed  Google Scholar 

  9. Goulet O, Sauvat F. Shourt bowel syndrome and intestinal transplantation in children. Curr Opin Clin Nutr Metab Care. 2006;9:304-313.

    Article  PubMed  Google Scholar 

  10. Rees CM, Pierro A, Eaton S. Neurodevelopmental outcomes of neonates with medically and surgically treated necrotizing enterocolitis. Arch Dis Child Fetal Neonatal Ed. 2007;92:F193-F198.

    Article  PubMed  Google Scholar 

  11. Dott NM. Anomalies of intestinal rotation: their embryology and surgical aspects – with report of five cases. Br J Surg. 1923;11:251-286.

    Article  Google Scholar 

  12. Mall FP. Development of the human intestine and its position in the adult. J Morphol. 1988;14:197-208.

    Google Scholar 

  13. Torres AM, Ziegler MM. Malrotation of the intestine. World J Surg. 1993;17:326-331.

    Article  PubMed  CAS  Google Scholar 

  14. Strouse PJ. Disorders of intestinal rotation and fixation (“malrotation”). Pediatr Radiol. 2004;34:837-851.

    Article  PubMed  Google Scholar 

  15. Kouwenberg M, Severijnen R, Kapusta L. Congenital cardiovascular defects in children with intestinal Malrotation. Pediatr Surg Int. 2008;24:257-263.

    Article  PubMed  CAS  Google Scholar 

  16. Applegate KE, Anderson JM, Klatte EC. Intestinal malrotation in children: a problem-solving approach to the upper gastrointestinal series. Radiographics. 2006;26:1485-1500.

    Article  PubMed  Google Scholar 

  17. Orzech N, Navarro OM, Langer JC. Is ultrasonography a good screening test for intestinal malrotation? J Pediatr Surg. 2006;41:1005-1009.

    Article  PubMed  Google Scholar 

  18. Ladd WE. Surgical disease of the alimentary tract in infants. N Engl J Med. 1936;215:705-708.

    Article  Google Scholar 

  19. Bass KD, Rothernberg SS, Chang JHT. Laparoscopic Ladd’s procedure in infants with malrotation. J Pediatr Surg. 1998;33:279-281.

    Article  PubMed  CAS  Google Scholar 

  20. Feitz R, Vos A. Malrotation: the post-operative period. J Pediatr Surg. 1997;32:1322-1324.

    Article  PubMed  CAS  Google Scholar 

  21. Bode L, Salvestrini C, Park PW, et al. Heparan sulfate and syndecan-1 are essential in maintaining murine and human intestinal epithelial barrier function. J Clin Invest. 2008;118:229-238.

    Article  PubMed  CAS  Google Scholar 

  22. Ostrow AM, Freeze H, Rychik J. Protein-losing enteropathy after fontan operation: investigations into possible pathophysiologic mechanisms. Ann Thorac Surg. 2006;82:695-700.

    Article  PubMed  Google Scholar 

  23. Gaynor W. The Fontan operation and modifications. In: Rychik J, Wernovsky G, eds. Hypoplastic Left Heart Syndrome. Norwell: Kluwer; 2003:149-165.

    Chapter  Google Scholar 

  24. Khairy P, Fernandes SM, Mayer JE, et al. Long-term survival, modes of death, and predictors of mortality in patients with Fontan surgery. Circulation. 2008;117:85-92.

    Article  PubMed  Google Scholar 

  25. Lenz D, Hambsch J, Schneider P, et al. Protein losing enteropathy in patients with Fontan circulation: is it triggered by infection. Crit Care. 2003;7:185-190.

    Article  PubMed  Google Scholar 

  26. Ryerson L, Goldberg C, Rosenthal A, Armstrong A. Usefulness of heparin therapy in protein-losing enteropathy associated with single ventricle palliation. Am J Cardiol. 2008;101:248-251.

    Article  PubMed  CAS  Google Scholar 

  27. Bhagirath KM, Tam JW. Resolution of protein-losing enteropathy with low-molecular weight heparin in an adult patient with Fontan palliation. Ann Thorac Surg. 2007;84:2110-2112.

    Article  PubMed  Google Scholar 

  28. Hsu DT, Naftel DC, Webber SA, et al. Lessons learned from the paediatric heart transplant study. Congenit Heart Dis. 2006;1:54-62.

    Article  PubMed  Google Scholar 

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Correspondence to Joanne K. Snyder .

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© 2009 Springer-Verlag London Limited

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Snyder, J.K., Barsness, K., Muñoz, R. (2009). Gastrointestinal Complications: Necrotizing Enterocolitis, Malrotation, and Protein Losing Enteropathy. In: Munoz, R., Morell, V., Cruz, E., Vetterly, C. (eds) Critical Care of Children with Heart Disease. Springer, London. https://doi.org/10.1007/978-1-84882-262-7_57

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  • DOI: https://doi.org/10.1007/978-1-84882-262-7_57

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