Extreme short-bowel syndrome in an infant

This full term male infant required a 90% enterectomy for congenital intestinal volvulus shortly after birth. The remaining small bowel consisted of 8 cm of proximal jejunum anastomosed to 5 cm of terminal ileum. The ileocecal valve was intact. Parenteral nutrition was administered for the first 21 months, including 17 months of home parenteral nutrition. The child's oral diet was mother's milk until 28 months of age when he was switched to an elemental diet. Solids were introduced at 6 months of age. Presently, at 36 months of age, the infant is off parenteral nutrition and is maintaining good nutritional status on a diet of 150 calories per kilo per day. His major problem has been an extreme allergy to cow's-milk protein. This infant is remarkable, since, despite record short bowel length, he maintained a completely normal growth and development, had remarkably few serious complications, spent relatively little time in hospital, and has documented improvement of G.I. absorption and radiographic contrast studies.