A case of dumping syndrome in a patient undergoing esophageal atresia surgery

Abstract

ileostomy because of an episode of marked abdominal overdistentionwith constipation and respiratorydifficulties.Manynutritional treatments were performed, with limited success, in order to gain a correct fluid balance and improve his growth: he was fed either orally or by percutaneous endoscopic gastrostomy. Themain limiting factor was the high fecal: 60g/kg/day. Finally treatment with loperamide (0.18mg/kg/die) and intermittent stool recycling (through the distal stoma) was successful with a consistent reductionof stooloutput, normalfluidandelectrolytebalanceandweight gain. He was discharged after 12 months with the recommendation to make: 2 milk meals and 2 baby food a day, cardiological treatment (propanolol andASA), intestinal decontamination, loperamide and stool recycling (2 times a day). Conclusions: Management of CIPO is often complex requiring pharmacological and nutritional support, and often surgical approaches. The combination of stool re-infusion and loperamide can be considered in patients with high stoma output and electrolytes imbalance, in order to limit the fluid loss and allow to gain weight.