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Review
. 2023 Jul;25(7):169-173.
doi: 10.1007/s11894-023-00873-w. Epub 2023 Jun 12.

Anastomotic Ulcers: Current Understanding of the Pathogenesis and Management

Affiliations
Review

Anastomotic Ulcers: Current Understanding of the Pathogenesis and Management

Shaunte McKay et al. Curr Gastroenterol Rep. 2023 Jul.

Abstract

Purpose of review: Anastomotic ulceration following intestinal resection is an under- recognized problem in pediatrics. We discuss the relevant literature regarding this condition.

Recent findings: Anastomotic Ulceration following intestinal resection is a potentially life threatening cause of refractory anemia. Evaluation should include correction of micronutrient deficiencies and endoscopic evaluation by upper and lower endoscopy and small intestinal endoscopy if necessary. Initial treatment by medical therapy may consist of anti-inflammatory agents as well as antibiotics to treat small intestinal bacterial overgrowth. Surgical resection should be considered if refractory to treatment. Anastomotic ulcers in pediatric patients with small bowel resection should be considered as a cause of refractory iron deficiency anemia. Endoscopic evaluation should be undertaken to look for evidence of anastomotic ulcers. Surgical resection should be considered if medical therapy fails.

Keywords: Anastomotic ulcer; GI bleeding; Intestinal failure; Short bowel syndrome.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Zullo A RL, Hassan C: Pathophysiology and Treatment of Anastomotic Ulcer: an emerging pathology. In: G G, ed. Endoscopic Follow-up of Digestive Anastomosis. Milan: Springer, 2014; 85–91.
    1. Chari ST, Keate RF. Ileocolonic anastomotic ulcers: a case series and review of the literature. Am J Gastroenterol. 2000;95:1239–43. - DOI - PubMed
    1. Cohran VC, Prozialeck JD, Cole CR. Redefining short bowel syndrome in the 21st century. Pediatr Res. 2017;81:540–9. - DOI - PubMed
    1. ••Fusaro F, Tambucci R, Romeo E, Bagolan P, Dall'Oglio L, Ceccarelli S, Francalanci P, et al. Anastomotic ulcers in short bowel syndrome: New suggestions from a multidisciplinary approach. J Pediatr Surg 2018;53:483–488. This study discusses options for therapy in anastomotic ulcers.
    1. Hirten RP, Ungaro RC, Castaneda D, Lopatin S, Sands BE, Colombel JF, Cohen BL. Anastomotic Ulcers After Ileocolic Resection for Crohn’s Disease Are Common and Predict Recurrence. Inflamm Bowel Dis. 2020;26:1050–8. - DOI - PubMed

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