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Updated: Aug 15, 2026
Tissue Engineering of the Intestine in a Murine Model
Published on: December 1, 2012
[Problems of extensive resection of small intestine in newborn infants and infants]
Insights
Massive small intestine resection in infants, often due to atresia or circulatory issues, impacts survival. Preserving specific intestinal sections is crucial for managing malabsorption syndromes and improving outcomes.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Neonatal care
Context:
- Massive small intestine resection in neonates and infants is primarily caused by atresias, stenosis, or circulatory disorders.
- The term "sub-total resection of the small intestine" lacks a standard definition, often referring to residual lengths of 75 cm or less.
- Survival after extensive intestinal resection depends critically on the preserved segment, with distal resections causing severe malabsorption.
Purpose:
- To review the implications of massive small intestine resection in neonates and infants.
- To highlight the importance of the preserved intestinal segment in determining post-resection outcomes.
- To discuss the patterns of functional recovery and potential compensatory mechanisms.
Summary:
- Survival is influenced by the absolute length and specific location of the remaining small intestine.
- Distal resections, particularly of the ileum, lead to severe malabsorption syndromes like chologenous diarrhea due to impaired bile acid absorption.
- While absorption functions show a recovery pattern, oral functions (carbohydrate absorption) recover faster than distal functions (lipid absorption).
- Compensatory mechanisms like intestinal lengthening or mucosal hypertrophy are occasionally observed but poorly understood.
Impact:
- Understanding the impact of intestinal resection location on malabsorption is critical for clinical management.
- Further research into compensatory mechanisms could lead to improved therapeutic strategies for neonates with short bowel syndrome.
- This review underscores the complexity of managing extensive small intestine resections in infants and the need for standardized definitions and further clinical investigation.
Abstract:
Massive resection of the small intestine in neonates and infants is mostly necessitated as a result of atresias, stenosis or circulatory disorders. At this period of life, the term "sub-total resection of the small intestine" is not applied in a standard way. Most authors use it when the residual small intestine is 75 cm or less in lenght. The survival prospects after sub-total resection of the small intestine are determined not only by the absolute length of the remaining small intestine; it is important which part can be preserved. Distal resections lead to a particularly serious malabsorption syndrome. In ileal resections, lipid absorption is disturbed owing to the lack of absorption of bile acids. A chologenous diarrhea results. The absorption functions (which are largely eliminated directly after the operation) recover in a regular pattern. The more orally localized functions (carbohydrate) recover more quickly than the more distally localized (lipid absorption). Surgical measures to slow the passage of intestinal contents have been applied with varying success in animal experiments. Clinical experience is largely lacking (only five cases). Various mechanisms for compensation after extensive resection of the small intestine in neonates (increase in length of the intestine, mucosal hypertrophy or greater cell density) are being discussed. These are only occasionally observed and the factors on which they depend are mostly obscure.
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