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Letter to the Editor in response to: Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enema

      We read with interest the article by Schattenkerk et al. [
      • Eeftinck Schattenkerk R.M.
      • Eeftinck Schattenkerk L.D.
      • Musters G.D.
      • van Schuppen J.
      • de jong J.R.
      • Gorter R.R.
      • et al.
      Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: an evaluation of the diagnostic accuracy of the contrast enema.
      ], regarding the use of routine contrast enema prior to stoma reversal and have undertaken a similar study in our institution with similar results. Over 5 years, from March 2016, we observed 43 infants (corrected gestational age <1 year at stoma reversal) in which necrotizing enterocolitis (NEC) was the most common pathology for stoma formation (n = 18, 42%). We excluded infants with Hirschsprung's disease as the indication for these imaging studies is to define anatomy rather than exclude a stricture. Our stricture rate at surgery was similar at 7.3% (n = 3) and was only seen in those who previously had NEC. Only one of these strictures was identified on routine contrast study (either contrast enema or antegrade loopogram study via the mucous fistula). Importantly, we had one major complication in an infant without NEC where at antegrade contrast study there was perforation of the mucous fistula into the peritoneum. This highlights even more so the importance of only undertaking contrast studies in infants at risk of stricturing disease which is those with previous NEC.
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      References

        • Eeftinck Schattenkerk R.M.
        • Eeftinck Schattenkerk L.D.
        • Musters G.D.
        • van Schuppen J.
        • de jong J.R.
        • Gorter R.R.
        • et al.
        Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: an evaluation of the diagnostic accuracy of the contrast enema.
        J Pediatr Surg. 2022;
        • Burnand K.M.
        • Zaparackaite I.
        • Lahiri R.P.
        • Parsons G.
        • Farrugia M.K.
        • Clarke S.A.
        • DeCaluwe D.
        • Haddad M.
        • Choudhry M.S.
        The value of contrast studies in the evaluation of bowel strictures after necrotising enterocolitis.
        Pediatr Surg Int. May 2016; 32: 465-470