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- Title
Management of small bowel volvulus around feeding Roux-en-Y limbs.
- Authors
Taylor, Janice A.; Ryckman, Frederick C.
- Abstract
<bold>Background: </bold>Patients' inability to take oral nutrition calls for alternative feeding. In selected pediatric patients, traditional feeding tubes are not tolerated and jejunal feeding tubes can be obstructive. One option is a Roux-en-Y feeding limb. Our institution noted complications secondary to small bowel volvulus around this limb. Goals of this study were to review patients who experienced volvulus after Roux-en-Y creation, and to identify factors contributing to this complication.<bold>Methods: </bold>Institutional review board approval was obtained for a retrospective chart review. 25 patients were identified as having a Roux-en-Y jejunal feeding limb. Five developed volvulus. Factors documented included age, time to complication, revision, and outcome.<bold>Results: </bold>Average age at limb creation was not statistically significant between those with or without volvulus. Mean time to obstruction was 228 +/- 117 days post-limb creation. Average limb length was 18.7 +/- 7 cm in patients with volvulus, 14 +/- 2.3 cm in patients without. 3 of 5 patients presenting with volvulus were discharged home after revision; two patients died.<bold>Conclusion: </bold>There is no definitive way to prevent small bowel volvulus around Roux-en-Y feeding limbs. No predictors of volvulus were identified. Once revised, no recurrences were observed. While this complication is uncommon, it has potentially catastrophic outcomes requiring early intervention.
- Subjects
VOLVULUS; BOWEL obstructions; JUVENILE diseases; ACUTE abdomen; PATIENTS; SMALL intestine surgery; AGE distribution; DISEASE complications; SMALL intestine; JEJUNOSTOMY; SURGICAL complications; TREATMENT effectiveness; RETROSPECTIVE studies; SURGICAL anastomosis
- Publication
Pediatric Surgery International, 2010, Vol 26, Issue 4, p439
- ISSN
0179-0358
- Publication type
journal article
- DOI
10.1007/s00383-010-2553-1