Five Cases of Neonatal Ileal Stoma Treated With Continuous Injection of Bicarbonated Ringer’s Solution Into the Anal Side

Abstract

In the management of neonatal ileostomy, reinjection of intestinal fluid to the stoma on the anal side has been reported. Nevertheless, with only the reinjection method, many cases require long-term central venous infusion. As an alternative to fluid and electrolyte replacement, we have attempted to inject bicarbonate Ringer’s solution, which is similar in composition to intestinal fluid, into the anal-side stoma in five patients. The diagnoses were meconium-related ileus in three patients and necrotizing enterocolitis and congenital ileal atresia in one patient each. The gestational age ranged from 25 to 37 weeks, and the birth weight ranged from 533 to 3,120 grams. The method resulted in weight gain (from 3.8 to 20.4 g/day) and improvement in serum HCO₃⁻ levels (from 18.8 to 22.9 mEq/ l) in all patients. The complications observed were edema and metabolic alkalosis in one patient each. Four patients could finish the central venous infusion before stoma closure, but one patient with edema could not finish it. This method was considered to have the potential as an alternative to intravenous infusion management for neonatal ileostomy.