Nutritional status following surgical correction of congenital gastrointestinal anomalies

A review of the literature reveals scanty data on the nutritional status of children following surgical correction of congenital intestinal anomalies in the neonatal period. Therefore, as part of the routine follow-up of 108 children who had undergone neonatal surgery, a simple nutritional assessment was performed. The diagnosis in these 108 children included: esophageal atresia; upper gastrointestinal obstruction; bowel resection; Hirschsprung's disease; imperforate anus; anterior abdominal wall defects; and miscellaneous. The follow-up period ranged from 2 wk to 9 yr after surgery. For each child the weight and height was plotted on a growth chart (National Center for Health Statistics). Seventy-six percent (82) of the children had weights and heights above the fifth percentile. The emphasis of this paper is on the 24% (26) of children whose weights and heights fell below the fifth percentile. The factors contributing to the retardation in growth were grouped as follows: (1) Undiagnosed, correctable surgical problems; (2) Undiagnosed correctable nonsurgical problems; (3) latrogenic complications; (4) Associated untreatable conditions; (5) Complications of the disease. Eleven (10% of the total) children had factors that were preventable or remediable. It is proposed that every neonate undergoing surgical correction of a congenital intestinal anomaly should be assessed and followed by a nutritional team consisting of a physician, nutritionist, and nurse. Nutritional parameters should be used in the assessment of long-term results following such surgery. In this way earlier recognition or prevention of factors contributing to growth retardation may be achieved.