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The Runs: Sudden Copious Ostomy Output in an Acolonic Hirschsprung Disease Patient with Short Gut Syndrome

  • Warapan Nakayuenyongsuk
  • Danielle Barnes
  • Brock Martin
  • Megan Christofferson
  • John Kerner
Stanford Multidisciplinary Seminars

Case Presentation and Evolution

A 7-year-old female with prior history of total colonic and ileal Hirschsprung disease was initially evaluated for very high ostomy output of unknown etiology. Her medical history had included extensive surgical interventions prior to 2 years of age to resect involved bowel. Those resections resulted in short gut (residual length of small bowel 145 cm), an end jejunostomy, and the absence of an ileocecal valve or colon. During those first 2 years, due in part to dilated proximal small bowel, she underwent three Serial Transverse Enteroplasty (STEP) procedures in order to lengthen and taper (narrow) her intestine [1, 2].

After this initial series of surgeries, total parenteral nutrition (TPN) support was given 7 days/week. To support adaptation and avoid complications, such as central line-associated bloodstream infections (CLABSIs), she was supplemented with glutamine, an ethanol lock was used per central venous line, and she was treated with antibiotics...

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Warapan Nakayuenyongsuk
    • 1
  • Danielle Barnes
    • 1
  • Brock Martin
    • 1
  • Megan Christofferson
    • 1
  • John Kerner
    • 1
  1. 1.Department of Pediatric GastroenterologyStanford University School of MedicineStanfordUSA

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