Pediatric Serial Transverse Enteroplasty (STEP) for Short Bowel Syndrome

Subject: A 2-year-old boy born at 39 weeks' gestation with bowel obstruction due to rare extensive Hirschsprung's Disease. Previous operations included exploratory laparotomy and proximal ileostomy with tunneled central venous line placement, suction rectal biopsy, leveling distal jejunostomy, and laparoscopic gastrostomy tube placement.

Diagnosis: The child had been on slow drip elemental formula feedings since birth. He was hospitalized six to eight times with dehydration and increased stoma output due to bacterial build up (short gut). His small bowel was significantly dilated (8 cm).

Treatment: Pediatric surgeon George M. Wadie, MD, performed a serial transverse enteroplasty (STEP) procedure with 23 firings of an endoscopic GIA stapler. The five-hour surgery lengthened the dilated segment from 65 cm to 120 cm with a 2-3 cm wide channel.

Outcome: The postoperative course was uncomplicated, and the child was discharged within three days. The patient eats normally and is weaning off overnight drip feedings. Future procedures may include endorectal pull-through.


George M. Wadie, MD

Board Certified, General Surgery, Sacred Heart Medical Center
Fellowship Trained, Pediatric Surgery
Special Interest in Pediatric Laparoscopic and Thoracoscopic Surgery
To Refer a Patient
Referring physicians can reach Dr. Wadie directly at (541) 501-1873.
Referral may also be made through the Patient Placement Center:
(541) 222-3000
(866) 267-9680 (toll free) 



Small bowel of 2 year old with short gut caused by extensive Hirschsprung's Disease.


Same patient's bowel after serial transverse enteroplasty (STEP).