Adverse effects of liver dysfunction and portal hypertension on intestinal adaptation in short bowel syndrome in children

Thomas R. Weber, Martin S. Keller, Kenric Murayama, Todd Maxon, Scott Peterson, Jon Thompson

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)582-586
Number of pages5
JournalAmerican journal of surgery
Volume184
Issue number6
DOIs
StatePublished - Dec 1 2002

Keywords

  • Adaptation
  • Portal hypertension
  • Short bowel

ASJC Scopus subject areas

  • Surgery

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