Biomaterial Database

Intestinal motility and jejunal feeding in children with chronic intestinal pseudo-obstruction. 1995

C Di Lorenzo, and A F Flores, and T Buie, and P E Hyman

Department of Pediatrics, Harbor-UCLA Medical Center, USA.

OBJECTIVE Total parenteral nutrition is responsible for most of the morbidity and mortality of childhood chronic intestinal pseudo-obstruction (CIP). The aim of this study was to determine if there are manometric patterns associated with the success of jejunal feedings in children with CIP. METHODS Eighteen children with CIP (age range, 1-9 years; mean, 4 years; 11 boys and 7 girls) were studied. All patients required parenteral nutrition or failed to thrive while receiving gastrostomy feedings. All underwent an antroduodenal manometry before surgical placement of a jejunostomy. Continuous drip jejunal feeding with an elemental formula was subsequently initiated. Follow-up after jejunal feeding was 1.6 years (range, 6 months to 4 years). Jejunal manometry was performed 2 months to 1 year after jejunostomy. RESULTS Jejunal feeding eliminated the need for parenteral nutrition in all 9 patients with migrating motor complex (MMC) and in 3 of 9 patients without MMC (P < 0.01). The MMC was present or absent in both antroduodenal and jejunal manometry in 14 of 18 children (77.7%). In 10 of 18 children (55%), duodenal and jejunal manometry showed similar qualitative abnormalities. CONCLUSIONS In selected children with CIP who fail gastrostomy feeding, jejunal tube feeding is an alternative to parenteral nutrition. The presence of MMCs is associated with a successful adaptation to jejunal feeding.

UI	MeSH Term	Description	Entries
D007223	Infant	A child between 1 and 23 months of age.	Infants
D007418	Intestinal Pseudo-Obstruction	A type of ILEUS, a functional not mechanical obstruction of the INTESTINES. This syndrome is caused by a large number of disorders involving the smooth muscles (MUSCLE, SMOOTH) or the NERVOUS SYSTEM.	CIPO,Chronic Idiopathic Intestinal Pseudo-Obstruction,Paralytic Ileus,Pseudo-Obstruction, Intestinal,Visceral Myopathy,Congenital Short Bowel Syndrome,Enteric Neuropathy,Intestinal Pseudo-Obstruction, Idiopathic,Intestinal Pseudoobstruction,Pseudointestinal Obstruction Syndrome,Pseudoobstructive Syndrome,Chronic Idiopathic Intestinal Pseudo Obstruction,Enteric Neuropathies,Idiopathic Intestinal Pseudo-Obstruction,Idiopathic Intestinal Pseudo-Obstructions,Intestinal Pseudo Obstruction,Intestinal Pseudo Obstruction, Idiopathic,Intestinal Pseudo-Obstructions,Intestinal Pseudo-Obstructions, Idiopathic,Intestinal Pseudoobstructions,Myopathy, Visceral,Neuropathy, Enteric,Obstruction Syndrome, Pseudointestinal,Pseudo Obstruction, Intestinal,Pseudointestinal Obstruction Syndromes,Pseudoobstruction, Intestinal,Pseudoobstructive Syndromes,Syndrome, Pseudointestinal Obstruction,Syndrome, Pseudoobstructive,Visceral Myopathies
D007582	Jejunostomy	Surgical formation of an opening through the ABDOMINAL WALL into the JEJUNUM, usually for enteral hyperalimentation.	Jejunostomies
D007583	Jejunum	The middle portion of the SMALL INTESTINE, between DUODENUM and ILEUM. It represents about 2/5 of the remaining portion of the small intestine below duodenum.	Jejunums
D008297	Male		Males
D008365	Manometry	Measurement of the pressure or tension of liquids or gases with a manometer.	Tonometry,Manometries
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D002675	Child, Preschool	A child between the ages of 2 and 5.	Children, Preschool,Preschool Child,Preschool Children
D002908	Chronic Disease	Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2).	Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D004386	Duodenum	The shortest and widest portion of the SMALL INTESTINE adjacent to the PYLORUS of the STOMACH. It is named for having the length equal to about the width of 12 fingers.	Duodenums