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[Short bowel syndrome. Still a current problem]

N Calomino1, M Malerba, G Oliva

  • 1Policlinico Le Scotte, Istituto di Clinica Chirurgica e Terapia Chirurgica, Università degli Studi di Siena.

Il Giornale Di Chirurgia
|June 1, 1997
PubMed
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Two patients with short bowel syndrome, resulting from intestinal resection, were successfully weaned from parenteral and enteral nutrition. This case study highlights recovery and improved quality of life after extensive bowel surgery.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Intensive Care Medicine

Background:

  • Intestinal infarction necessitates extensive bowel resection, potentially leading to short bowel syndrome.
  • Loss of the ileocecal (Bauhin) valve can exacerbate malabsorption in short bowel syndrome patients.

Observation:

  • Two patients presented with clinical features of intestinal infarct requiring significant intestinal resection (40 cm and 50 cm residual bowel).
  • Ileocecal valve integrity was compromised in both cases due to the primary surgery or prior malignancy resection.
  • Postoperative management involved intensive care unit (ICU) stay followed by a phased transition from total parenteral nutrition (TPN) to enteral nutrition, and finally to oral diet.

Findings:

  • Both patients achieved complete weaning from artificial nutrition (parenteral and enteral).

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  • Patients demonstrated stabilization with a good quality of life during quarterly follow-up.
  • The management strategy resulted in significant savings in healthcare costs.

    • Implications:

    • Aggressive intestinal resection for infarct, even with compromised ileocecal valve, can be managed successfully.
    • A structured, phased nutritional rehabilitation approach is effective for patients with short bowel syndrome.
    • Successful conservative management of short bowel syndrome can improve patient outcomes and reduce healthcare expenditure.