Infusion of Intestinal Fluid Into Distal Jejunostomy/Ileostomy in Premature Infants

Abstract

Purpose: To prevent nutritional and hepatic disorders and intestinal disuse atrophy in premature infants with jejunostomy/ileostomy, we have performed frequent and safe infusion of intestinal fluid through an indwelling distal intestinal tube and a divided stoma.

Methods: The cases of seven premature infants who underwent infusion of intestinal fluid into distal jejunostomy/ileostomy in our department from 2014 to 2016 were reviewed retrospectively.

Results: There were four infants with necrotizing enterocolitis, two with meconium-related ileus, and one with focal intestinal perforation. Jejunostomy and ileostomy were placed in four and three patients, respectively, and double-barreled, divided, and loop stomata were created in three, three, and one, respectively. A distal intestinal tube was inserted on postoperative days 20–92, and intestinal fluid was collected and infused into the distal stoma through the tube every 1–3 hours. A divided stoma made these procedures safe and easy since no pouch was needed for a distal stoma, and the inserted tube was easy to maintain. After starting the infusion, weight increased and hepatic disorder improved in seven and four patients, respectively. No complications directly from these procedures were observed. Seven patients underwent stoma closure after 20–149 days of intestinal fluid infusion.

Conclusions: The infusion of intestinal fluid through an indwelling tube in the distal stoma was found to be safe and easy, and seemed effective for realizing weight gain. A divided jejunostomy/ileostomy was also useful for easy and safe infusion, and stoma and tube management. Further study will confirm the present results and reveal a better procedure.