Anastomotic Ulcers: Current Understanding of the Pathogenesis and Management

Curr Gastroenterol Rep. 2023 Jul;25(7):169-173. doi: 10.1007/s11894-023-00873-w. Epub 2023 Jun 12.


Purpose of review: Anastomotic ulceration following intestinal resection is an under- recognized problem in pediatrics. We discuss the relevant literature regarding this condition.

Recent findings: Anastomotic Ulceration following intestinal resection is a potentially life threatening cause of refractory anemia. Evaluation should include correction of micronutrient deficiencies and endoscopic evaluation by upper and lower endoscopy and small intestinal endoscopy if necessary. Initial treatment by medical therapy may consist of anti-inflammatory agents as well as antibiotics to treat small intestinal bacterial overgrowth. Surgical resection should be considered if refractory to treatment. Anastomotic ulcers in pediatric patients with small bowel resection should be considered as a cause of refractory iron deficiency anemia. Endoscopic evaluation should be undertaken to look for evidence of anastomotic ulcers. Surgical resection should be considered if medical therapy fails.

Keywords: Anastomotic ulcer; GI bleeding; Intestinal failure; Short bowel syndrome.

Publication types

  • Review

MeSH terms

  • Biopsy
  • Child
  • Endoscopy, Gastrointestinal
  • Gastrointestinal Diseases*
  • Humans
  • Intestines
  • Ulcer* / diagnosis
  • Ulcer* / etiology
  • Ulcer* / therapy