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Short bowel syndrome and intestinal lengthening procedures

Pediatric Surgery: Diagnosis and Treatment, Page: 345-356
2022
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Metric Options:   Counts1 Year3 Year

Book Chapter Description

1. Following small bowel resection, the intestine in patients with short bowel syndrome (SBS) undergoes compensatory adaptive changes to increase functional nutrient and water absorption. Loss of the distal ileum is associated with least favorable adaptation, owing to the presence of specialized epithelial cells in the ileum that are critical for fat absorption, and which secrete hormones involved in intestinal transit and mucosal growth. 2. Intestinal loss and dependence on parenteral nutrition have significant physiologic consequences for patients with SBS. Multidisciplinary intestinal rehabilitation programs coordinate medical and surgical interventions for these patients, to optimize intestinal adaptation, prevent complications of SBS, and accelerate weaning from parenteral nutrition. 3. Small intestinal lengthening procedures and intestinal transplant are surgical interventions that can improve outcomes in patients with SBS. Intestinal lengthening procedures can increase bowel function and surface area, to aid in weaning from parenteral nutrition, whereas intestinal transplant can be considered in patients with parenteral nutrition failure.

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