Related Experiment Video
Updated: May 9, 2026
Tissue Engineering of the Intestine in a Murine Model
Published on: December 1, 2012
Successful rehabilitation in pediatric ultrashort small bowel syndrome
Benjamin J Infantino1, David F Mercer, Brandy D Hobson
1Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE.
Insights
Pediatric patients with ultrashort small bowel (USSB) syndrome have a high survival rate in intestinal rehabilitation programs (IRPs). About half achieve parenteral nutrition (PN) independence, with improved growth and liver health.
Area of Science:
- Pediatric Gastroenterology
- Intestinal Rehabilitation
- Short Bowel Syndrome
Background:
- Ultrashort small bowel (USSB) syndrome presents significant challenges for pediatric patients.
- Intestinal rehabilitation programs (IRPs) aim to improve outcomes for these complex cases.
Purpose of the Study:
- To evaluate treatment outcomes for pediatric patients with USSB within an IRP.
- To identify factors associated with successful parenteral nutrition (PN) independence.
Main Methods:
- Retrospective review of 28 pediatric patients with USSB (≤ 20 cm small bowel) treated between 2001-2011.
- Univariate analysis comparing characteristics of patients achieving PN independence versus those who did not.
- Comparison of growth and nutritional status from enrollment to follow-up using Wilcoxon signed-rank test.
Main Results:
- 96% survival rate among identified patients.
- 48% of survivors achieved PN independence with their native bowel.
- Improvements in PN intake, bilirubin levels, and growth z-scores observed; hepatic transaminases did not improve in non-rehabilitated patients.
Conclusions:
- IRP enrollment offers a high survival probability for children with USSB.
- Intact ileocecal valve and colon are associated with, but not required for, successful rehabilitation.
- Approximately 50% of USSB patients can achieve reduced PN dependence, improved liver function, and enhanced growth.
Objective:
To examine treatment outcomes in pediatric patients with ultrashort small bowel (USSB) syndrome in an intestinal rehabilitation program (IRP).
Study Design:
We reviewed IRP records for 2001-2011 and identified 28 children with USSB (≤ 20 cm of small bowel). We performed univariate analysis using the Fisher exact test and Wilcoxon rank-sum test to compare characteristics of children who achieved parenteral nutrition (PN) independence with intact native bowel and those who did not. Growth, nutritional status, and hepatic laboratory test results were compared from the time of enrollment to the most recent values using the Wilcoxon signed-rank test.
Results:
Of the 28 patients identified, 27 (96%) survived. Almost one-half (48%) of these survivors achieved PN independence with their native bowel. The successfully rehabilitated patients were more likely to have an intact colon and ileocecal valve (P = .01). Significant improvements in PN kcal/kg, total bilirubin, and height and weight z-scores were seen in all patients, but serum hepatic transaminase levels did not improve in the nonrehabilitated patients.
Conclusion:
Enrollment in an IRP provides an excellent probability of survival for children with USSB. The presence of an intact ileocecal valve and colon are positively associated with rehabilitation in this population, but are not requisite. Approximately one-half of patients with USSB can achieve rehabilitation, with a median time to PN independence of less than 2 years. The USSB population can attain reduced PN dependence, improvement of PN-associated liver disease, and enhanced growth with the aid of an IRP.
