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Journal of Nutrition and Metabolism
Volume 2014, Article ID 850820, 6 pages
Research Article

A Modern Cohort of Duodenal Obstruction Patients: Predictors of Delayed Transition to Full Enteral Nutrition

1Department of Pediatric Surgery, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Fegan Building, 3rd Floor, Boston, MA 02215, USA
2Department of Pediatric Surgery, Children’s Hospital of Alabama, Birmingham, AL 35233, USA
3Department of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA
4Department of Anesthesia, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02215, USA
5Pediatric Surgical Associates, Children’s Hospitals and Clinics of Minnesota, MN 55404, USA

Received 28 May 2014; Accepted 28 July 2014; Published 14 August 2014

Academic Editor: Johannes B. van Goudoever

Copyright © 2014 Sigrid Bairdain et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. A common site for neonatal intestinal obstruction is the duodenum. Delayed establishment of enteral nutritional autonomy continues to challenge surgeons and, since early institution of nutritional support is critical in postoperative newborns, identification of patients likely to require alternative nutritional support may improve their outcomes. Therefore, we aimed to investigate risk factors leading to delayed establishment of full enteral nutrition in these patients. Methods. 87 patients who were surgically treated for intrinsic duodenal obstructions from 1998 to 2012 were reviewed. Variables were tested as potential risk factors. Median time to full enteral nutrition was estimated using the Kaplan-Meier method. Independent risk factors of delayed transition were identified using the multivariate Cox proportional hazards regression model. Results. Median time to transition to full enteral nutrition was 12 days (interquartile range: 9–17 days). Multivariate Cox analysis identified three significant risk factors for delayed enteral nutrition: gestational age (GA) ≤ 35 weeks (), congenital heart disease (CHD) (), and malrotation (). Conclusions. CHD and Prematurity are most commonly associated with delayed transition to full enteral nutrition. Thus, in these patients, supportive nutrition should strongly be considered pending enteral nutritional autonomy.