Repeat serial transverse enteroplasty leads to reduction in parenteral nutrition in children with short bowel syndrome

2020 ◽  
Author(s):  
David F. Mercer ◽  
Tyler R. Burnett ◽  
Brandy D. Hobson ◽  
Samantha J Logan ◽  
Brandi K. Gerhardt ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Short Bowel ◽  
Serial Transverse Enteroplasty

scholarly journals Serial transverse enteroplasty and nipple valve construction, two life saving techniques for patients with short bowel syndrome, a report of 5 cases

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mojtaba Shafiekhani ◽  
Nazanin Azadeh ◽  
Kiarash Ashrafzadeh ◽  
Maryam Esmaeili ◽  
Hamed Nikoupour
Keyword(s):  
Small Intestine ◽  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Intestinal Adaptation ◽  
Ileocecal Valve ◽  
Intestinal Transit Time ◽  
Short Bowel ◽  
Nipple Valve ◽  
Gastrointestinal Reconstruction ◽  
Serial Transverse Enteroplasty

Abstract Background Various abdominal pathologies end up with surgical resection of small intestine. When the small intestine remnant is too short for adequate fluid and micronutrients absorption, short bowel syndrome is diagnosed. The disabling condition needs a multidisciplinary approach to design parenteral nutrition, care for thrombotic, hepatic and infectious complications and gradually wean the patient from parenteral nutrition. Various surgical techniques have been introduced to increase absorptive mucosa and enhance the intestinal adaptation process. Serial transverse enteroplasty and nipple valve reconstruction are among the procedures, which will be discussed in the current article. Case presentation Herein, we presented 5 cases of short bowel syndrome as a consequence of abdominal laparotomies, patients were referred to our center to receive parenteral nutrition and to be prepared for the final autologous gastrointestinal reconstruction or intestinal transplantation, if indicated. Conclusion Patient’s age, performance status and bowel remnant length determines the appropriate technique for autologous gastrointestinal reconstruction. Serial transverse enteroplasty is designed to increase bowel’s length by creating zigzag patterns through dilated bowel loops. Presence of ileocecal valve is crucial to delay intestinal transit time and to prevent colonic bacterial transfer to ileum. Patient’s with ileocecal valve loss benefit from creating an artificial valve, namely, nipple valve.

scholarly journals Incidence and Outcomes of Home Parenteral Nutrition in Patients With Crohn Disease in Olmsted County, Minnesota

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Zeinab Bakhshi ◽  
Siddhant Yadav ◽  
Bradley R Salonen ◽  
Sara L Bonnes ◽  
Jithinraj Edakkanambeth Varayil ◽  
...  
Keyword(s):  
Weight Loss ◽  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Crohn Disease ◽  
Severe Disease ◽  
Bloodstream Infections ◽  
Home Parenteral Nutrition ◽  
Average Weight ◽  
Olmsted County ◽  
Short Bowel

Abstract Background We sought to estimate the incidence of home parenteral nutrition (HPN) use in a population-based cohort of patients with Crohn disease (CD), and to assess clinical outcomes and complications associated with HPN. Methods We used the Rochester Epidemiology Project (REP) to identify residents of Olmsted County, who were diagnosed with CD between 1970 and 2011, and required HPN. Results Fourteen out of 429 patients (3.3%) with CD received HPN (86% female). Eleven patients (79%) had moderate–severe CD and 12 patients (86%) had fistulizing disease. Thirteen patients (93%) underwent surgery, primarily due to obstruction. Among CD incidence cases, the cumulative incidence of HPN from the date of CD diagnosis was 0% at 1 year, 0.5% at 5 years, 0.8% at 10 years, and 2.4% at 20 years. Indications for HPN included short bowel syndrome in 64%, malnutrition in 29%, and bowel rest in 21%. The median duration of HPN was 2.5 years. There was an average weight gain of 1.2 kg at 6 months, an average weight loss of 1.4 kg at 1 year, and a further weight loss of 2.2 kg at 2 years from the start of HPN. Patients were hospitalized a mean of 5 times after the start of HPN, mainly due to catheter-related bloodstream infections and thrombosis. Conclusions Less than 4% of patients with CD need HPN. Most have moderate to severe disease with short bowel syndrome or malnutrition. Possible reasons for the patients’ weight loss could be noncompliance, and increased metabolic needs because of active disease.

Low-dose growth hormone in adult home parenteral nutrition–dependent short bowel syndrome patients: A positive study

2003 ◽  
Vol 124 (2) ◽  
pp. 293-302 ◽  
Author(s):  
David Seguy ◽  
Kouroche Vahedi ◽  
Nathalie Kapel ◽  
Jean–Claude Souberbielle ◽  
Bernard Messing
Keyword(s):  
Growth Hormone ◽  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Low Dose ◽  
Home Parenteral Nutrition ◽  
Short Bowel ◽  
Positive Study

scholarly journals RARE CASE OF SHORT BOWEL SYNDROME

2019 ◽  
Vol 49 ◽  
pp. 6-8
Author(s):  
Azmaiparashvili G. აზმაიფარაშვილი გ. ◽  
Tomadze G. თომაძე გ. ◽  
Megreladze A. მეგრელაძე ა.
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Rare Case ◽  
Postoperative Management ◽  
Hepatic Flexure ◽  
Postoperative Treatment ◽  
Extensive Resection ◽  
Short Bowel

Short bowel syndrome is characterized by malabsorption following extensive resection of the small bowel. It may occur after resection of more than 50% and is certain after resection of more than 70% of the small intestine, or if less than 100 cm of small bowel remains.  Successful postoperative management of short bowel syndrome has been discussed. Patient was operated because of cancer of hepatic flexure of large bowel with invasion in stomach, pancreas, retroperitoneal space, mesentery of small bowel. Right sided colectomy and excessive resection of small bowel with limphodissection was performed and only 80 cm of small bowel was left together with the left part of the colon. Ileotransversoanastomosis was performed. After the adequate course of chemotherapy and partial parenteral nutrition patient’s general condition became satisfactory. Patient started to gain weight. Adequate postoperative treatment determined postoperative period without surgical and nutritional complication.

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