Short bowel syndrome

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Short bowel syndrome is a diagnosis that is a significant life burden for the child and his or her caregivers. It typically results from the loss of a large segment of the small intestine leading to malabsorption of nutrients. In the most severe form of intestinal failure, the patient is dependent on intravenous nutrition for survival. It was historically felt to lead only to a devastating outcome. Rapid advances in intestinal failure management have led to dramatic improvements in survival and to the achievement of the twin goals of enteral tolerance and TPN independence in most children formerly felt to be beyond hope. Best managed in specialized centers, children are initially given full TPN support including specialized lipid preparations. Early restoration of intestinal continuity and initiation of enteral feeds are standard. Children should be monitored for progress in advancing enteral feeds and reducing TPN support. If this process fails, consideration of operative intervention and enteroplasty should be made. When efforts at intestinal rehabilitation fail and children develop life-threatening complications, they should be considered for intestinal transplantation. An intensive multidisciplinary approach to management should prevent intestinal failure from ever again being considered a hopeless diagnosis.

Original languageEnglish (US)
Title of host publicationFundamentals of Pediatric Surgery, Second Edition
PublisherSpringer International Publishing
Pages421-430
Number of pages10
ISBN (Electronic)9783319274430
ISBN (Print)9783319274416
DOIs
StatePublished - Jan 1 2016

Keywords

  • Enteral feeding
  • Enteroplasty
  • Ethanol locks
  • Intestinal failure
  • Intestinal transplantation
  • LILT procedure
  • Lipid emulsions
  • STEP procedure
  • Short bowel syndrome
  • TPN
  • Total parenteral nutrition

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Mercer, D. F. (2016). Short bowel syndrome. In Fundamentals of Pediatric Surgery, Second Edition (pp. 421-430). Springer International Publishing. https://doi.org/10.1007/978-3-319-27443-0_51