The bacterial communities of the small intestine and stool in children with short bowel syndrome

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.

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Clinical case and short review of extreme short bowel syndrome: an update 21 years after

Italian Journal of Medicine ◽

10.4081/itjm.2016.543 ◽

2016 ◽

Vol 10 (1) ◽

pp. 45

Author(s):

Pasquale Mansueto ◽

Aurelio Seidita ◽

Salvatore Iacono ◽

Antonio Carroccio

Keyword(s):

Small Intestine ◽

Short Bowel Syndrome ◽

Clinical Case ◽

Ileocecal Valve ◽

Short Review ◽

Short Bowel ◽

Massive Resection ◽

Low Weight ◽

Clinical Conditions

Short bowel syndrome refers to the malabsorptive state caused by loss of significant portions of the small intestine, whose clinical framework is characterized by malnutrition, diarrhea, dehydration, weight loss, and low-weight-related symptoms/signs. These clinical conditions seem to be related to the length of resection. Twenty-one years ago we reported the clinical case of an infant, who underwent a massive resection of the loops of the small intestine, of the cecum and of part of the ascending colon, due to intestinal malrotation with volvulus. The residual small intestine measured just 11 cm and consisted of the duodenum and a small part of jejunum, in the absence of the ileocecal valve, configuring the case of a <em>ultra-short bowel syndrome</em>. In this report, we update the case, reporting the patient succeeded to obtain a good weight gain and to conduct a quite normal lifestyle, despite the long-term consequences of such resection.

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RARE CASE OF SHORT BOWEL SYNDROME

TSMU COLLECTION OF SCIENTIFIC WORKS ◽

10.52340/csw.v49i0.137 ◽

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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Short Bowel Syndrome

10.2310/gastro.5448 ◽

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.

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Longitudinal Division of Small Intestine: A Surgical Possibility for Children with the Very Short Bowel Syndrome

European Journal of Pediatric Surgery ◽

10.1055/s-2008-1059781 ◽

1985 ◽

Vol 40 (04) ◽

pp. 233-236 ◽

Cited By ~ 1

Author(s):

Y. Aigrain ◽

D. Cornet ◽

J. Cezard ◽

M. Boureau

Keyword(s):

Small Intestine ◽

Short Bowel Syndrome ◽

Short Bowel ◽

Longitudinal Division

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Short-Bowel Syndrome Associated with Subtotal Necrosis of Small Intestine after Rectal Trauma

European Journal of Pediatric Surgery ◽

10.1055/s-2008-1072256 ◽

1999 ◽

Vol 9 (04) ◽

pp. 251-252 ◽

Cited By ~ 3

Author(s):

G. Pomberger ◽

U. Hallwirth ◽

W. Pumberger ◽

E. Horcher

Keyword(s):

Small Intestine ◽

Short Bowel Syndrome ◽

Short Bowel ◽

Rectal Trauma

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Short-bowel syndrome associated with subtotal necrosis of small intestine after rectal trauma

Journal of Pediatric Surgery ◽

10.1016/s0022-3468(00)90248-3 ◽

2000 ◽

Vol 35 (3) ◽

pp. 534

Author(s):

Thomas A. Angerpointner

Keyword(s):

Small Intestine ◽

Short Bowel Syndrome ◽

Short Bowel ◽

Rectal Trauma

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Tissue engineering for compensating short bowel syndrome

Vestnik of Russian military medical Academy ◽

10.17816/brmma12376 ◽

2018 ◽

Vol 20 (2) ◽

pp. 259-264

Author(s):

A V Kosulin ◽

L N Beldiman ◽

S V Kromsky ◽

A A Kokorina ◽

E V Mikhailova ◽

...

Keyword(s):

Tissue Engineering ◽

Small Intestine ◽

Short Bowel Syndrome ◽

Mechanical Stability ◽

Clinical Problem ◽

Cell Types ◽

Short Bowel ◽

Wide Range

Short bowel syndrome is an important clinical problem characterized by a high incidence of serious complications, deaths and socioeconomic consequences. Parenteral nutrition provides only a temporary solution without reducing the risk of complications. This applies equally to surgical treatment, in particular to small intestine transplantation and related concomitant interventions, which only facilitate the adaptation of the intestine to new conditions. Potential approaches have been analyzed in the treatment of the syndrome of the small intestine, which can be offered by dynamically developing tissue engineering. Various types of carriers and cell types that are used in experiments for obtaining tissue engineering designs of the intestine are discussed. A wide range of variants of such constructions is analyzed that can lead to obtaining an organ prosthesis with a cellular organization and mechanical stability similar to those of the native small intestine, which will ensure the necessary biocompatibility. It is established that one of the optimal carriers for today are extracellular matrices obtained by decellularization of the native small intestine. This process allows to preserve the microarchitecture of the small intestine, which greatly facilitates the process of filling the matrix with cells both in vitro and in vivo. It has also been established that mesenchymal stromal multipotent cells and organoid units obtained from the tissue of the native small intestine are particularly prominent among the most promising participants in the cellular ensemble.

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