Abstract
Purpose: To measure the prevalence of dietary protein enterocolitis among congenital heart disease patients undergoing cardiac surgical procedures, and to identify risk factors in those patients. Patients and Methods: A retrospective chart review was conducted for 451 patients with congenital heart disease undergoing cardiac surgical procedures in the infant period at Chiba Children's Hospital. Results: Among the 451 patients, 14 received a diagnosis of dietary protein enterocolitis. Nine patients were excluded due to congenital malformations of the alimentary tract or acute epidemic gastroenteritis, as other risk factors for development of dietary protein enterocolitis. In the remaining five patients with dietary protein enterocolitis, we assessed associations between congenital heart disease or operation and dietary protein enterocolitis. The prevalence of dietary protein enterocolitis was 5/451 (1.1%). These five patients had high pulmonary flow or underwent systemic-to-pulmonary artery shunting associated with congenital heart diseases. High pulmonary flow or systemic-to-pulmonary artery shunting lead to low intestinal blood flow. The clinical course of these five patients suggests that neonates and infants with these conditions were more likely to develop dietary protein enterocolitis. Conclusion: Patients such as these with low intestinal blood flow should be monitored closely, and appropriate nutritional support is needed to prevent the development of dietary protein enterocolitis.
