Malnutrition, malabsorption, and/or fluid and electrolyte loss after extensive small-bowel resection
- Markedly decreased mucosal surface area due to resection
- Loss of trophic hormones
- Loss of peptide hormones that regulate motility
- Abnormal transit
- Malabsorption of protein, fat, carbohydrate, vitamins, electrolytes, and trace elements, depending on site of resected intestine
- Patient can lose as much as half of intestine if the duodenum, distal ileum, and ileocecal valve (ICV) are present.
- If the ICV is gone, patients may not be able to tolerate even a 25% loss of intestine without the help of parenteral nutrition (PN).
- Normal bowel length: 150–200 cm, 26 weeks’ gestation; 200–300 cm at birth in full-term infant; 600–800 cm, adult
- Infants have low intestinal reserve; do not tolerate resection as well as do adults.
- However, long-term prognosis is often better because of hypertrophy and hyperplasia of the intestine.
- Gastric acid hypersecretion occurs soon after intestinal resection but is transient.
- Bowel adaptation can occur over time. Increased surface area due to bowel dilatation, villous hypertrophy, and bowel lengthening can occur. Stimulation of luminal contents is needed for bowel growth, and factors such as glutamine, short-chain fatty acids, tropic hormones, and growth factors may be important for bowel growth.
- Infants: intestinal resection for necrotizing enterocolitis
- Congenital anomalies include intestinal atresias, gastroschisis, omphalocele, and meconium ileus.
- Malrotation may result in volvulus with bowel resection secondary to ischemic injury.
- Older children: neoplasms and radiation enteritis
- Intestinal resection secondary to Crohn disease, trauma, pseudoobstruction syndrome
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Cabana, Michael D., editor. "Short-Bowel Syndrome." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. 5-Minute Clinical Consult, www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14198/all/Short_Bowel_Syndrome.
Short-Bowel Syndrome. In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14198/all/Short_Bowel_Syndrome. Accessed June 3, 2023.
Short-Bowel Syndrome. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14198/all/Short_Bowel_Syndrome
Short-Bowel Syndrome [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2023 June 03]. Available from: https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14198/all/Short_Bowel_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Short-Bowel Syndrome ID - 14198 ED - Cabana,Michael D, BT - Select 5-Minute Pediatrics Topics UR - https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14198/all/Short_Bowel_Syndrome PB - Wolters Kluwer Health ET - 7 DB - 5-Minute Clinical Consult DP - Unbound Medicine ER -