Document Detail


Adverse effects of liver dysfunction and portal hypertension on intestinal adaptation in short bowel syndrome in children.
MedLine Citation:
PMID:  12488176     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The effects of liver dysfunction and portal hypertension on intestinal adaptation in short bowel syndrome are generally unknown. The presence of these disorders may adversely affect the ability to wean these patients from parenteral nutrition. METHODS: Forty-two infants with short bowel syndrome were placed in one of three Child's classifications, depending on serum bilirubin, prothrombin time, ascites, albumin, and liver biopsy, and compared for time to diet tolerance, time required for parenteral nutrition, and survival. A subgroup of these patients also underwent portal pressure measurement, which was combined with liver biopsy results to compare three groups for the same parameters. RESULTS: Survival was Child's class A 100%, B 84%, C 61%, while time to feeding tolerance was A 16.3 days, B 20.0 days, C 28 days, and total parenteral nutrition time was A 80.0 days, B 98.0 days, C 100.0 days. In the groups that underwent portal pressure measurement, the survival was group I (normal biopsy and pressure) 100%, group II (abnormal biopsy and normal pressure) 90%, group III (abnormal biopsy and pressure) 66%, while time to feeding tolerance was I 15.0 days, II 18.0 days, III 24.0 days, and total parenteral nutrition time was I 72.0 days, II 94.0 days, III 184.0 days. CONCLUSIONS: Cholestatic liver disease, especially associated with portal hypertension adversely affects bowel adaptation in short bowel syndrome.
Authors:
Thomas R Weber; Martin S Keller
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  184     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-18     Completed Date:  2003-01-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  582-6; discussion 586     Citation Subset:  AIM; IM    
Affiliation:
Division of Pediatric Surgery, Department of Surgery, Saint Louis University School of Medicine, Cardinal Glennon Children's Hospital, 1465 South Grand Blvd., MO 63104, USA. Weberm2@slu.edu
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MeSH Terms
Descriptor/Qualifier:
Cholestasis, Intrahepatic / etiology,  physiopathology*
Digestive System Surgical Procedures / adverse effects
Enterocolitis, Necrotizing / surgery
Feeding Methods
Humans
Hypertension, Portal / etiology,  physiopathology*
Infant, Newborn
Intestines / physiopathology*
Severity of Illness Index
Short Bowel Syndrome / etiology,  physiopathology*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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