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.

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 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

Fecal Microbiome and Bile Acid Metabolome in Adult Short Bowel Syndrome

2021 ◽  
Author(s):  
Harold J. Boutte ◽  
Jacqueline Chen ◽  
Todd N. Wylie ◽  
Kristine M. Wylie ◽  
Yan Xie ◽  
...  
Keyword(s):  
Bile Acid ◽  
Gut Microbiota ◽  
Short Bowel Syndrome ◽  
Lithocholic Acid ◽  
Intestinal Failure ◽  
Patient Specific ◽  
Rrna Gene ◽  
Healthy Controls ◽  
Fecal Microbiome ◽  
Short Bowel

Background & Aims: Loss of functional small bowel surface area causes short bowel syndrome (SBS), intestinal failure, and parenteral nutrition (PN) dependence. The gut adaptive response following resection may be difficult to predict, and it may take up to two years to determine which patients will wean from PN. Here we examined features of gut microbiota and bile acid (BA) metabolism in determining adaptation and ability to wean from PN. Methods: Stool and sera were collected from healthy controls and from SBS patients (n=52) with ileostomy, jejunostomy, ileocolonic and jejunocolonic anastomoses fed with PN plus enteral nutrition or who were exclusively enterally fed. We undertook 16S rRNA gene sequencing, BA profiling and 7α-hydroxy-4-cholesten-3-one (C4) quantitation with LC-MS/MS, and serum amino acid analyses. Results: SBS patients exhibited altered gut microbiota with reduced gut microbial diversity compared to healthy controls. We observed differences in the microbiomes of SBS patients with ileostomy vs. jejunostomy, jejunocolonic vs. ileocolonic anastomoses, and PN-dependence compared to those who weaned from PN. Stool and serum BA composition and C4 concentrations were also altered in SBS patients, reflecting adaptive changes in enterohepatic BA cycling. Stools from patients who weaned from PN were enriched in secondary BAs including deoxycholic acid and lithocholic acid. Conclusions: Shifts in gut microbiota and BA metabolites may generate a favorable luminal environment in select SBS patients, promoting the ability to wean from PN. Pro-adaptive microbial species and select BA may provide novel targets for patient-specific therapies for SBS.

scholarly journals Measurement of Utilities Associated with Parenteral Support Requirement in Patients with Short Bowel Syndrome and Intestinal Failure

2018 ◽  
Vol 40 (11) ◽  
pp. 1878-1893.e1 ◽  
Author(s):  
Rachel Ballinger ◽  
Jake Macey ◽  
Andrew Lloyd ◽  
John Brazier ◽  
Joanne Ablett ◽  
...  
Keyword(s):  
Short Bowel Syndrome ◽  
Intestinal Failure ◽  
Short Bowel ◽  
Parenteral Support

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

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.

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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