Laparoscopic jejunostomy in a child with chronic intestinal pseudobstruction Li Voti G., Amoroso S.,Milazzo M. Objective os the study: chronic intestinal pseudo obstruction (CIP) is a severe condition characterized by recurrent symptoms of bowel obstruction, in the absence of lumen occluding lesions. Because of motility disorders, since neonatal age these children show failure to thrive,vomiting,constipation and malnutrition. Long term enteral nutritional support, by gastrostomy or jejunostomy, appears the gold treatment. We performed a laparoscopy assisted jejunostomy in a patient with CIP. Our technique is described and results discussed. Methods and procedures: a 14 years old male child, affected by CIP, was admitted to our unit with severe malnutrition. He had undergone,two years before, a duodeno jejunal anastomosis because of o diagnosis of duodenal compression by superior mesenteric artery. He had no improvement from this operation. Xray study demonstrated a persistent gastroparesis. A short term trial of nasojejunal feeding was effective in weight gain. Because of special anatomical pattern determined from previous operation we performed a laparoscopy assisted jejunostomy and inserted a mic key button for feeding. A 5 mm laparoscopic camera poprt was placed through the umbilicus, by an open access. Two further 5 mm ports were placed in the left lower quadrant and in the cross point of umbilical transverse line and left breast midline. The camera was moved to the inferior port site. Avoding adhesions we managed to find the first jejunal loop. A bowel segment, approximately ten cm distal to the ligament of Treitz, was softly grasped and brought up to the abdominal wall at the left upper port site. Bowel was secured to abdominal wall by few unabsorbable sutures and minimally ostomy was done in order to insert the jejunostomy button. The correct position of the button was checked by laparoscopy. Enteral nutrition restarted via nasojejunal tube 3 days postoperatively and via jejunostomy 8 days later. We observed no intraoperative cpmplications or difficulties because of previous surgery adhesions. Conclusions: laparoscopy assisted jejunostomy is a safe and effective procedure to achieving enteral access in patients with CIP.

LI VOTI G, AMOROSO S, MILAZZO M (2005). Laparoscopic jejunostomy in a child with chronic intestinal pseudobstruction. JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES, 15, 222-222.

Laparoscopic jejunostomy in a child with chronic intestinal pseudobstruction

LI VOTI, Giuseppe;
2005-01-01

Abstract

Laparoscopic jejunostomy in a child with chronic intestinal pseudobstruction Li Voti G., Amoroso S.,Milazzo M. Objective os the study: chronic intestinal pseudo obstruction (CIP) is a severe condition characterized by recurrent symptoms of bowel obstruction, in the absence of lumen occluding lesions. Because of motility disorders, since neonatal age these children show failure to thrive,vomiting,constipation and malnutrition. Long term enteral nutritional support, by gastrostomy or jejunostomy, appears the gold treatment. We performed a laparoscopy assisted jejunostomy in a patient with CIP. Our technique is described and results discussed. Methods and procedures: a 14 years old male child, affected by CIP, was admitted to our unit with severe malnutrition. He had undergone,two years before, a duodeno jejunal anastomosis because of o diagnosis of duodenal compression by superior mesenteric artery. He had no improvement from this operation. Xray study demonstrated a persistent gastroparesis. A short term trial of nasojejunal feeding was effective in weight gain. Because of special anatomical pattern determined from previous operation we performed a laparoscopy assisted jejunostomy and inserted a mic key button for feeding. A 5 mm laparoscopic camera poprt was placed through the umbilicus, by an open access. Two further 5 mm ports were placed in the left lower quadrant and in the cross point of umbilical transverse line and left breast midline. The camera was moved to the inferior port site. Avoding adhesions we managed to find the first jejunal loop. A bowel segment, approximately ten cm distal to the ligament of Treitz, was softly grasped and brought up to the abdominal wall at the left upper port site. Bowel was secured to abdominal wall by few unabsorbable sutures and minimally ostomy was done in order to insert the jejunostomy button. The correct position of the button was checked by laparoscopy. Enteral nutrition restarted via nasojejunal tube 3 days postoperatively and via jejunostomy 8 days later. We observed no intraoperative cpmplications or difficulties because of previous surgery adhesions. Conclusions: laparoscopy assisted jejunostomy is a safe and effective procedure to achieving enteral access in patients with CIP.
2005
LI VOTI G, AMOROSO S, MILAZZO M (2005). Laparoscopic jejunostomy in a child with chronic intestinal pseudobstruction. JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES, 15, 222-222.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/31455
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