Document Detail

Pediatric short bowel syndrome: adaptation after massive small bowel resection.
MedLine Citation:
PMID:  17667718     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Short bowel syndrome (SBS) develops after massive small bowel resections. Patients with less than 12 cm of jejunoileum have a slim possibility of being weaned from parenteral nutrition (PN). PATIENTS AND METHODS: In a retrospective review of records of consecutive patients with SBS, 8 patients were evaluated for treatment by adaptation and weaning from PN. These included 4 patients with class I SBS (0-10 cm of small bowel), one with class II SBS (>10-25 cm), one with class III SBS (>25-50 cm), and 2 with class IV SBS (>50-75 cm). Adaptation was assessed by measuring growth in the small bowel and the ability to be weaned from PN. RESULTS: Adaptation was achieved primarily by extending the length of jejunoileum by approximately 450% over the first 2.5 years after resection and by increasing the degree of colonic fermentation and absorption of nutrients. As of July 1, 2005, all of the patients were off PN, with the exception of 2 patients with class I-A SBS: patient 3 had a remaining jejunoileum of only 2.5 cm and patient 4 had a remaining jejunoileum of 9 cm but developed eosinophilic enterocolitis. These 2 patients continued with PN on alternate months. CONCLUSIONS: Bowel growth after massive small bowel resection provides an objective parameter of adaptation and a means of predicting ability to be weaned from PN. Aggressive nutritional support makes even patients with class I SBS, whose disease was previously considered hopeless, likely candidates to achieve freedom from PN.
Ljubomir Rossi; Padmalatha Kadamba; Claes Hugosson; Edward B De Vol; Zakaria Habib; Saleh Al-Nassar
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  45     ISSN:  1536-4801     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-01     Completed Date:  2007-09-20     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  213-21     Citation Subset:  IM    
Department of Pediatric Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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MeSH Terms
Adaptation, Physiological*
Colon / metabolism,  microbiology,  pathology
Duodenum / metabolism,  pathology
Infant Nutritional Physiological Phenomena*
Intestinal Absorption
Parenteral Nutrition* / adverse effects
Retrospective Studies
Severity of Illness Index
Short Bowel Syndrome / mortality,  pathology*,  surgery*
Treatment Outcome

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