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Abstract
【Abstract】 Objective To explore the related problems of nutrition management and operation of
neonates after enterostomy diagnosed as intestinal failure associated liver disease(IFALD)，and evaluate
the prognosis of these neonates. Methods To retrospectively analyze the clinical date of 18 neonates with
IFALD in Department of Pediatric Surgery，Bayi Children's Hospital Affiliated to the Seventh Medical
Center of PLA General Hospital from January 2016 to December 2018. Nutritional support was given to all
patients after enterostomy and gradually changed into enteral nutrition. However, they had varying degrees ofdependence on intravenous nutrition support and were combined with IFALD eventually. Though we carriedout the individual nutrition management in accordance with the guidelines of the European Association ofPediatric Gastroenterology, Hepatology and Nutrition and the clinical experience from our study center,children with liver function injury and cholestasis showed a progressive aggravation trend, and difficultiesin further parenteral nutrition and weight gain. Thus they were forced to perform enterostomy closure inadvance. Results After the operation, 16 patients were finally transited to complete enteral nutrition, totallyseparated from intravenous nutrition and reached the discharge criteria. After 2-6 months of follow-up, the bilirubinlevel and liver function of them was restored to normal with an ideal catch-up in weight. Complications occurredin 4 cases，one patient died of infection and disseminated intravascular coagulation(DIC) during conservativetreatment for adhesive intestinal obstruction; one patient suffered from anastomotic stenosis, followed byincomplete intestinal obstruction characterized by abdominal distention after increasing the volume of milk feeding.The operation was carried out once again 2 months after the ostomy, removing the anastomotic stenosis andreperforming the enteroanastomosis. The patient recovered 1 month after the surgery. One month after discharge,his liver function and bilirubin level had turned to normal. Among the patients discharging from the hospital,one case had different degrees of diarrhea and needed intermittent treatments to manage the symptoms includingdehydration due to massive resection of his ileocecal and colon. Conclusion For neonates with liver diseaseassociated with IFALD after enterostomy, rational nutrition strategy and appropriate opportunity of enterostomyclosure may improve the prognosis
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2021, Vol. 9 
