Late intestinal stricture formation occurring between distal contrast study and delayed elective stoma closure after perforated necrotizing enterocolitis

Abstract

We present an unusual case of delayed distal colonic stricture following ileostomy formation in a term infant with significant atrioventricular septal defect and ischaemic small bowel perforation. Contrast studies performed 2 months after ileostomy formation detected a stricture at the transverse colon, but did not detect a distal colonic stricture. Ileostomy closure was delayed due to Covid 19 restrictions and the second stricture was not anticipated preoperatively, leading to major postoperative complications. This case highlights the need to perform timely distal contrast studies, preferably within 6–8 weeks prior to planned stoma closure in complex children with significant underlying comorbidities.

Keywords

• Necrotizing enterocolitis
• Intestinal stricture
• Congenital heart disease