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A 32-year-old woman suffered massive infarction of the small bowel and after surgical resection was left with only 40 cm of postduodenal small bowel. She was maintained initially on total parenteral nutrition (TPN), but because of poor compliance with her dietary regimen she had a stormy course when given enteral feedings. With intensive counseling her compliance improved and she was able to maintain good nutritional status with oral feeding. This case report illustrates the need for intensive nutritional support for patients with short bowel. Although initial survival depends on TPN, it should be followed by an aggressive attempt to use enteral feedings alone. The program should be individualized, and caregivers must be aware of the many potential complications, since early diagnosis and treatment of complications may be critical for survival.
A 32-year-old woman suffered massive infarction of the small bowel and after surgical resection was left with only 40 cm of postduodenal small bowel. She was maintained initially on total parenteral nutrition (TPN), but because of poor compliance with her dietary regimen she had a stormy course when given enteral feedings. With intensive counseling her compliance improved and she was able to maintain good nutritional status with oral feeding. This case report illustrates the need for intensive nutritional support for patients with short bowel. Although initial survival depends on TPN, it should be followed by an aggressive attempt to use enteral feedings alone. The program should be individualized, and caregivers must be aware of the many potential complications, since early diagnosis and treatment of complications may be critical for survival.