Massive Small Bowel Resection in the Neonate

Arch Surg. 1976;111(4):500. doi:10.1001/archsurg.1976.01360220196038.
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To the Editor.–The article, "Massive Small Bowel Resection in the Neonate," by Aaronson et al (110:1485, 1975) is an important contribution documenting the ability of an infant to survive with only 17 cm of small bowel. This infant may, however, have had 29% of its small bowel removed unnecessarily. Although excision of the proximal dilated segment of small bowel in small intestinal atresia is recommended, it may not always be possible and in some circumstances seems quite undesirable. This is particularly true (1) in proximal jejunal atresia where the dilated segment may extend to the ligament of Treitz and (2) where multiple atretic segments are present and excision of the dilated bowel would compromise the amount of absorptive surface. An alternative approach is to perform a tapering jejunoplasty, removing a triangular segment of the antimesenteric border of the dilated jejunum.1 This causes a gradual reduction in the caliber


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