[Problems of extensive resection of small intestine in newborn infants and infants].
Massive resection of the small intestine in neonates and infants is mostly necessitated as a result of atresias, stenosis or circulatory disorders. At this period of life, the term "sub-total resection of the small intestine" is not applied in a standard way. Most authors use it when the residual small intestine is 75 cm or less in lenght. The survival prospects after sub-total resection of the small intestine are determined not only by the absolute length of the remaining small intestine; it is important which part can be preserved. Distal resections lead to a particularly serious malabsorption syndrome. In ileal resections, lipid absorption is disturbed owing to the lack of absorption of bile acids. A chologenous diarrhea results. The absorption functions (which are largely eliminated directly after the operation) recover in a regular pattern. The more orally localized functions (carbohydrate) recover more quickly than the more distally localized (lipid absorption). Surgical measures to slow the passage of intestinal contents have been applied with varying success in animal experiments. Clinical experience is largely lacking (only five cases). Various mechanisms for compensation after extensive resection of the small intestine in neonates (increase in length of the intestine, mucosal hypertrophy or greater cell density) are being discussed. These are only occasionally observed and the factors on which they depend are mostly obscure.
D000367:Age Factors; D001647:Bile Acids and Salts / Q000378:metabolism; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007408:Intestinal Absorption; D007421:Intestine, Small / Q000033:anatomy & histology / Q000601:surgery*; D050356:Lipid Metabolism; D008286:Malabsorption Syndromes / Q000209:etiology; D008722:Methods; D011183:Postoperative Complications
D001647:Bile Acids and Salts
Probleme der ausgedehnten Dünndarmresektion im Neugeborenen- und Säuglingsalter