The following is a summary of “Chronic Mucosal Inflammation in Pediatric Intestinal Failure Patients—A Unique Phenomenon,” published in the August 2023 issue of Pediatrics by Moran-Lev, et al.

With improvements in intestinal failure (IF) management and increased long-term survival rates, the physiological complications of the condition have become more evident. Among the complications, chronic intestinal inflammation resembling inflammatory bowel disease (IBD) has been reported in the IF population. However, detailed literature on the condition remained scarce. For a study, researchers sought to characterize children with IF who have developed chronic intestinal inflammation and identify potential clinical factors that may predispose them to the condition.

A retrospective analysis was conducted using electronic medical records of pediatric patients treated at Cincinnati Children’s Hospital Medical Center from January 2000 to July 2022. Demographic and medical history data were collected and compared between children with IF who developed chronic intestinal inflammation and those who did not.

During the follow-up period, 23 children were diagnosed with chronic intestinal inflammation. Among them, 12 (52%) were males, with a median age of 4.5 years (range: 3–7) at diagnosis. The most common underlying conditions in these patients were gastroschisis (31%), necrotizing enterocolitis (26%), and malrotation with volvulus (21.7%). Notably, a higher proportion of children in the chronic intestinal inflammation group lacked an ileocecal valve (ICV) and adjoining distal ileum compared to the short bowel syndrome (SBS)-IF control group (65% vs. 33%, respectively). Additionally, more children in the chronic intestinal inflammation group had undergone prior lengthening procedures compared to the SBS-IF control group (21.7% vs. 0, respectively).

Children with short bowel syndrome (SBS) were at risk of developing early-onset chronic intestinal inflammation. The absence of an ileocecal valve (and adjoining ileum) and prior lengthening procedures were associated with an increased risk of IBD-like conditions in these patients. The study shed light on potential predisposing factors and helped understand the development of chronic intestinal inflammation in the context of IF management.

Source: journals.lww.com/jpgn/Abstract/2023/08000/Chronic_Mucosal_Inflammation_in_Pediatric.15.aspx