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Lethal short-bowel syndrome.

B J Hancock1, N E Wiseman

  • 1Department of Pediatric General Surgery, University of Manitoba, Winnipeg, Canada.

Journal of Pediatric Surgery
|November 1, 1990
PubMed
Summary
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Infants with severe short bowel syndrome often have poor outcomes despite medical and surgical interventions. Survival is unlikely for infants with less than 6 cm of small bowel, suggesting limited benefits of further treatment.

Area of Science:

  • Pediatric surgery
  • Gastroenterology
  • Neonatal intensive care

Background:

  • Short bowel syndrome (SBS) in infants presents significant management challenges.
  • Current supportive measures including parenteral nutrition and surgical interventions offer limited success.
  • Severe SBS often leads to poor prognoses and high mortality rates.

Purpose of the Study:

  • To review outcomes of infants diagnosed with severe short bowel syndrome.
  • To evaluate the efficacy of current management strategies for SBS.
  • To determine prognostic indicators for survival in infants with SBS.

Main Methods:

  • Retrospective review of seven infants with severe SBS.
  • Analysis of causes including volvulus, atresias, and intestinal aganglionosis.

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  • Documentation of surgical procedures, total parenteral nutrition (TPN) duration, and survival times.

    • Main Results:

    • Survival ranged from 15 days to 8 months, with death averaging 9 weeks post-diagnosis.
    • Infants with less than 6 cm of small bowel beyond the Ligament of Treitz had an inevitably fatal outcome.
    • TPN-related complications, including liver dysfunction and failure, were observed in multiple infants.

    Conclusions:

    • Severe SBS in infants, particularly with limited bowel length (<6 cm), is associated with a grim prognosis.
    • While interventions may prolong survival, they do not alter the ultimate outcome and increase morbidity.
    • Withholding further therapy upon diagnosis may be a reasonable consideration given the limited therapeutic options and poor prognosis.