GASTROINTESTINAL-BLEEDING DUE TO DELAYED PERIANASTOMOTIC ULCERATION IN CHILDREN

Delayed perianastomotic ulcers are a poorly recognized complication of intestinal surgery. We report two patients with this complication of their remote intestinal surgery who developed significant iron deficie ncy anemia. Patient 1 had intestinal resection for perforated necrotiz ing enterocolitis as a newborn and presented at 16 yr of age with an u lcer at the ileocolonic anastomosis. Patient 2 had intestinal resectio n for strangulated internal hernia at 9 yr and was diagnosed with two ulcers at the ileoileal anastomosis at 14 yr of age. Fifteen patients with delayed anastomotic ulcers have so far been reported in the liter ature. We add two more cases and also emphasize the difficulty in esta blishing the diagnosis and importance of performing a retrograde ileos copy.