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Medical and Surgical Aspects of Intestinal Failure in the Child

Danielle Wendel1, Patrick J Javid1

  • 1University of Washington School of Medicine, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA.

The Surgical Clinics of North America
|October 9, 2022
PubMed

Insights

Children with intestinal failure now have improved life expectancy due to advancements in parenteral nutrition and surgical techniques. Intestinal rehabilitation aims for enteral autonomy, reducing the need for intestinal transplantation.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Nutritional Support

Background:

  • Children with intestinal failure historically faced poor prognoses.
  • Advances in medical and surgical care have significantly improved outcomes.
  • Parenteral nutrition and surgical interventions are key to managing this condition.

Purpose of the Study:

  • To review the evolution of medical and surgical care for pediatric intestinal failure.
  • To highlight improvements in long-term survival and quality of life.
  • To discuss current strategies in intestinal rehabilitation and the declining role of transplantation.

Main Methods:

  • Review of current literature on pediatric intestinal failure management.
  • Analysis of trends in parenteral nutrition safety and efficacy.
  • Evaluation of surgical techniques for bowel lengthening and tapering.

Main Results:

  • Long-term life expectancy is now common in children with intestinal failure, even with very short bowel lengths.
  • Parenteral nutrition is safer with reduced risk of liver injury due to lipid formulation changes.
  • Surgical techniques for bowel lengthening and tapering effectively increase absorptive capacity.

Conclusions:

  • Modern medical and surgical care has transformed the prognosis for children with intestinal failure.
  • Intestinal rehabilitation strategies are effective in achieving enteral autonomy.
  • The utilization of intestinal transplantation has decreased due to these advancements.

Keywords:
Bowel lengtheningBowel taperingIntestinal adaptationIntestinal failureParenteral nutritionPediatricShort bowel syndrome

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