Letter to the Editor

It was with interest we read Wales et al's report on the management of five patients with congenital ultra-short bowel [1]. The concept of iatrogenic bowel obstruction to induce bowel dilatation with a view to subsequent lengthening surgery is not new. Georgeson and colleagues described the technique of using a nipple valve to partially obstruct and expand a proximal bowel segment for the purpose of delayed bowel lengthening in 1994 [2]. Since then, we have published our series of 10 patients managed by intermittently obstructing tube stomas to achieve controlled bowel expansion for subsequent longitudinal intestinal lengthening and tailoring [3].