[Long-term parenteral nutrition in vascular-induced short bowel syndrome]

Mesenteric vascular occlusion with intestinal infarction is often regarded as a fatal illness. Often the diagnosis of severe ischemia is made during laparotomy. Sometimes resection is not performed because the conditions is thought to be incurable, and in such cases the mortality is 100%. If radical and aggressive resection is carried out even at the site of almost complete small bowel infarction and followed by an elective second-look operation, survival can be achieved in some patients. The motivation to attempt treatment should be further enhanced by the observation that the short-bowel syndrome following resection can be successfully treated, giving an acceptable quality of life for the patients. Between 1 January 1979 and 31 December 1979 we treated 9 male and 6 female patients with short-bowel syndrome after mesenteric occlusive disease; their ages ranged between 4 and 78 years, and the total duration of parenteral nutrition was 30,494 patient-days. With a median of 1503 days, the longest individual periods of parenteral nutrition were 4,919 and 5,015 days. We show the problems of long-term parenteral nutrition, including catheter-associated and nutritional complications, with reference to the individual courses of patients with short-bowel syndrome after mesenteric infarction. Despite some problems, patients of all ages can return to near-normality with an acceptable quality of life with the aid of parenteral nutrition at home.