INTESTINAL MOTILITY AND JEJUNAL FEEDING IN CHILDREN WITH CHRONIC INTESTINAL PSEUDOOBSTRUCTION

Background/Aims: Total parenteral nutrition is responsible for most of the morbidity and mortality of childhood chronic intestinal pseudo-obstruction (CIP), The aim of this study was to determine if there ave manometric patterns associated with the success of jejunal feedings in children with CIP, Methods: Eighteen children with CIP (age range, 1-9 years; mean, 4 years; 11 boys and 7 girls) were studied, All patients required parenteral nutrition or failed to thrive while receiving gastrostomy feedings, All underwent an antroduodenal manometry before surgical placement of a jejunostomy, Continuous drip jejunal feeding with an elemental formula was subsequently initiated, Follow-up after jejunal feeding was 1.6 years (range, 6 months to 4 years), Jejunal manometry was performed 2 months to 1 year after jejunostomy, Results: Jejunal feeding eliminated the need for parenteral nutrition in all 9 patients with migrating motor complex (MMC) and in 3 of 9 patients without MMC (P < 0.01), The MMC was present or absent in both antroduodenal and jejunal manometry in 14 of 18 children (77.7%), In 10 of 18 children (55%), duodenal and jejunal manometry showed similar qualitative abnormalities. Conclusions: In selected children with CIP who fail gastrostomy feeding, jejunal tube feeding is an alternative to parenteral nutrition, The presence of MMCs is associated with a successful adaptation to jejunal feeding.