Short Bowel Syndrome

2015 ◽  
Author(s):  
Robert Burakoff ◽  
Alison Goldin
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Average Length ◽  
Intestinal Failure ◽  
Clinical Manifestations ◽  
Intestinal Resection ◽  
Intestinal Atresia ◽  
Congenital Defects ◽  
Short Bowel ◽  
Vascular Insufficiency

Short bowel syndrome (SBS) is a state of malabsorption resulting from physical or functional loss of large portions of the small intestine, and is the most common cause of intestinal failure. The average length of a human’s small intestine is between 3 and 8 m, depending on the type of measurements made (surgical, radiologic, or autopsy); SBS occurs when less than 200 cm of small bowel remains. SBS may be congenital (intestinal atresia) or acquired. Physical losses usually occur from surgical resection for Crohn disease (CD), vascular insufficiency, radiation, malignancy, trauma, or volvulus. The site of intestinal resection helps to determine the degree of intestinal capacity. Functional losses, on the other hand, are less common and occur in the setting of a nonfunctioning, but intact, small intestine. Examples include radiation enteritis, congenital defects, and inflammatory bowel disease (IBD). This review addresses the epidemiology, pathophysiology and pathogenesis, clinical manifestations, treatment, complications, and prognosis of SBS. A figure shows sites of intestinal nutrient absorption. A table lists potential complications of SBS in patients receiving parenteral nutrition (PN). This review contains 1 highly rendered figure, 1 table, and 67 references. 

scholarly journals Biodistribution of the radiophamarceutical sodium pertechnetate (Na99mTcO4) after massive small bowel resection in rats

2007 ◽  
Vol 22 (6) ◽  
pp. 430-435 ◽  
Author(s):  
Dâmaso de Araújo Chacon ◽  
Irami Araújo-Filho ◽  
Arthur Villarim-Neto ◽  
Amália Cínthia Meneses Rêgo ◽  
Ítalo Medeiros Azevedo ◽  
...  
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Intestinal Mucosa ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Control Group ◽  
Short Bowel ◽  
Massive Resection ◽  
Mucosal Thickness ◽  
Misleading Interpretation

PURPOSE: To evaluate the biodistribution of sodium pertecnetate (Na99mTcO4) in organs and tissues, the morphometry of remnant intestinal mucosa and ponderal evolution in rats subjected to massive resection of the small intestine. METHODS: Twenty-one Wistar rats were randomly divided into three groups of 7 animals each. The short bowel (SB) group was subjected to massive resection of the small intestine; the control group (C) rats were not operated on, and soft intestinal handling was performed in sham rats. The animals were weighed weekly. On the 30th postoperative day, 0.l mL of Na99mTcO4, with mean activity of 0.66 MBq was injected intravenously into the orbital plexus. After 30 minutes, the rats were killed with an overdose of anesthetic, and fragments of the liver, spleen, pancreas, stomach, duodenum, small intestine, thyroid, lung, heart, kidney, bladder, muscle, femur and brain were harvested. The biopsies were washed with 0.9% NaCl.,The radioactivity was counted using Gama Counter WizardTM 1470, PerkinElmer. The percentage of radioactivity per gram of tissue (%ATI/g) was calculated. Biopsies of the remaining jejunum were analysed by HE staining to obtain mucosal thickness. Analysis of variance (ANOVA) and the Tukey test for multiple comparisons were used, considering p<0.05 as significant. RESULTS: There were no significant differences in %ATI/g of the Na99mTcO4 in the organs of the groups studied (p>0.05). An increase in the weight of the SB rats was observed after the second postoperative week. The jejunal mucosal thickness of the SB rats was significantly greater than that of C and sham rats (p<0.05). CONCLUSION: In rats with experimentally-produced short bowel syndrome, an adaptive response by the intestinal mucosa reduced weight loss. The biodistribution of Na99mTcO4 was not affected by massive intestinal resection, suggesting that short bowel syndrome is not the cause of misleading interpretation, if an examination using this radiopharmaceutical is indicated.

scholarly journals Short bowel syndrome

2017 ◽  
Vol 89 (12-2) ◽  
pp. 144-149
Author(s):  
A I Parfenov ◽  
E A Sabelnikova ◽  
T N Kuzmina
Keyword(s):  
Short Bowel Syndrome ◽  
Clinical Manifestations ◽  
Intestinal Resection ◽  
Short Bowel

The paper gives information on the classification, pathogenesis, and clinical manifestations of short bowel syndrome following after intestinal resection. It discusses the treatment and rehabilitation of patients with this condition.

scholarly journals Consideration of Intestinal Failure in Cases of De-Adaptation of Short Bowel Syndrome: A Case Report and Descriptive Review

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1660
Author(s):  
Tasuku Kato ◽  
Yasuhisa Nakano ◽  
Fumiko Yamane ◽  
Ryuichi Ohta ◽  
Chiaki Sano
Keyword(s):  
Short Bowel Syndrome ◽  
Case Reports ◽  
Intestinal Failure ◽  
Intestinal Resection ◽  
Electrolyte Imbalance ◽  
Routine Practice ◽  
Intestinal Function ◽  
Short Bowel ◽  
First Time ◽  
The Relationship

Short bowel syndrome (SBS) causes malabsorption due to extensive intestinal resection. While intestinal function declines with age, little is known about the relationship between intestinal failure and ageing. For the first time in Japan, we report a case of de-adaptation of SBS thought to be due to ageing, in a 93-year-old woman who presented with electrolyte imbalance and malnutrition. She had undergone five surgical resections of the small intestine over the past 20 years. She had developed SBS once due to multiple surgeries, but due to compensatory function, the symptoms had abated. However, due to decreased intestinal function caused by ageing, it worsened and symptoms reappeared. A literature search for the period January 1990 to May 2021 in Ichushi a major journal in Japan, found that de-adaptation of SBS occurred in 23 previous cases, of which we were able to confirm the details in 17 cases, with no case reports on “de-adaptation of SBS”, demonstrating that the concept of “intestinal failure” has only recently begun to be used in routine practice. Therefore, we stress the importance of re-emphasizing the concept of ”intestinal failure” in everyday practice, as well as other organ-related conditions such as cardiac or renal failure, as this may lead to a better understanding of the pathogenesis of malnutrition and diarrhoea in elderly patients.

scholarly journals Biomechanical Force Prediction for Lengthening of Small Intestine during Distraction Enterogenesis

2020 ◽  
Vol 7 (4) ◽  
pp. 140
Author(s):  
Hadi S. Hosseini ◽  
James C. Y. Dunn
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Computational Models ◽  
Intestinal Failure ◽  
Mechanical Force ◽  
Tissue Response ◽  
Complication Rates ◽  
Short Bowel ◽  
Safe Delivery ◽  
Biomechanical Force

Distraction enterogenesis has been extensively studied as a potential treatment for short bowel syndrome, which is the most common form of intestinal failure. Different strategies including parenteral nutrition and surgical lengthening to manage patients with short bowel syndrome are associated with high complication rates. More recently, self-expanding springs have been used to lengthen the small intestine using an intraluminal axial mechanical force, where this biomechanical force stimulates the growth and elongation of the small intestine. Differences in physical characteristics of patients with short bowel syndrome would require a different mechanical force—this is crucial in order to achieve an efficient and safe lengthening outcome. In this study, we aimed to predict the required mechanical force for each potential intestinal size. Based on our previous experimental observations and computational findings, we integrated our experimental measurements of patient biometrics along with mechanical characterization of the soft tissue into our numerical simulations to develop a series of computational models. These computational models can predict the required mechanical force for any potential patient where this can be advantageous in predicting an individual’s tissue response to spring-mediated distraction enterogenesis and can be used toward a safe delivery of the mechanical force.

scholarly journals Multiple intestinal anastomosis in newborns and infants

2021 ◽  
Vol 25 (3) ◽  
pp. 153-157
Author(s):  
Yu. A. Kozlov ◽  
M. N. Mochalov ◽  
K. A. Kovalkov ◽  
S. S. Poloyan ◽  
P. Zh. Baradieva ◽  
...  
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Necrotizing Enterocolitis ◽  
Average Length ◽  
Intestinal Anastomosis ◽  
Abdominal Cavity ◽  
Average Weight ◽  
Intestinal Anastomoses ◽  
Short Bowel ◽  
Second Surgery

Introduction. The present trial systematizes data, taken from one surgical center as an example, on treating patients with intestinal atresia and necrotizing enterocolitis with multiple intestinal anastomoses.Material and methods. The trial is a retrospective review on the treatment of 13 newborn infants who since 2010 have been put multiple intestinal anastomoses; the treatment was approved by the Hospital Ethics Committee. The average gestational age of patients was 31.2 weeks. The average age at the time of surgery – 7,9 days. Average weight - 2007 grams. The average number of anastomoses was 3.7 (range: 2-7). The average length of remained small intestine after the second surgery was 67.4 cm (range: 12-120 cm). No other surgical procedures, including gastrostomy or enterostomy, were performed. In all cases, surgical intervention ended with hermetic suturing of the abdominal cavity. Among them, there were 6 patients with the multifocal form of necrotizing enterocolitis; 6 patients had type IV atresia of the small intestine; 1 patient had the Ladd’s syndrome. Connection of intestinal segments was made by constructing several “end-to-end” anastomoses, double-row precision seam with PDS II 7/0 suture.Results. In the postoperative period, complications associated with anastomosis construction, such as leakage and narrowing, were not recorded. Transit function of the gastrointestinal tract restored on day 4, on average, after the surgery (range: 2-6 days). There were no early lethal outcomes within the first 28 days after the surgery which were associated with the surgery. 2 patients with short bowel syndrome (remained small intestine was 12 and 25 cm) and multivisceral disorders died on day 72 and 64 after the surgery. Survived patients were transferred to full enteral feeding in 56 days, in average, after the second surgery (range - 15-120 days).Conclusion. In our study, we have demonstrated potentials of a new surgical approach: one-stage formation of multiple intestinal anastomoses in case of multiple intestinal atresias as well as in case of multifocal forms of necrotizing enterocolitis. Maintaining the bowel length with multiple bowel anastomoses is very important factor for better survival of patients with the short bowel syndrome.  

scholarly journals Energy absorption as a measure of intestinal failure in the short bowel syndrome.

Gut ◽  
1989 ◽  
Vol 30 (2) ◽  
pp. 176-183 ◽  
Author(s):  
C A Rodrigues ◽  
J E Lennard-Jones ◽  
D G Thompson ◽  
M J Farthing
Keyword(s):  
Energy Absorption ◽  
Short Bowel Syndrome ◽  
Intestinal Failure ◽  
Short Bowel

Intestinal Failure and Short Bowel Syndrome

Medicine ◽  
2003 ◽  
Vol 31 (3) ◽  
pp. 98-100 ◽  
Author(s):  
Alastair Forbes
Keyword(s):  
Short Bowel Syndrome ◽  
Intestinal Failure ◽  
Short Bowel
Sign in / Sign up

Export Citation Format

Share Document