[Short bowel syndrome]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Clinical Nutrition

Background:

• Intestinal infarct necessitates extensive bowel resection, potentially leading to short bowel syndrome.
• Preservation of the ileocecal valve (Bauin valve) is crucial for intestinal function but may not always be feasible due to prior surgery or disease.
• Management of short bowel syndrome requires careful nutritional support to ensure patient recovery and long-term well-being.

Observation:

• Two patients with intestinal infarct underwent significant intestinal resection, resulting in residual bowel lengths of 40 cm and 50 cm.
• In one case, the ileocecal valve was sacrificed during a previous operation for cecal neoplasm; in the other, it could not be preserved during the resection.
• Postoperatively, patients required intensive care followed by total parenteral nutrition, gradually transitioning to enteral nutrition and then an oral diet.

Findings:

• Patients successfully weaned off artificial nutrition (parenteral and enteral) after a period of intensive nutritional management.
• Both patients achieved stabilization with independent oral intake.
• A good quality of life was reported by both patients despite the extensive bowel resection and loss of the ileocecal valve.

Implications:

• Extensive intestinal resection for infarct, even with loss of the ileocecal valve, can be managed successfully with tailored nutritional strategies.
• Early and progressive nutritional rehabilitation is key to achieving independence from artificial nutrition and improving patient outcomes.
• This case series highlights the potential for recovery and good quality of life in patients with short bowel syndrome following major intestinal surgery.