[Surgical managements of massive involvement of small bowel and of short gut syndrome].
Despite the recent advent of total parenteral nutrition (TPN), the long-term survival of the patients with short gut syndrome is not satisfactory with complications of catheter-related sepsis and cholestasis. The causes of short gut syndrome in pediatric surgery are multiple intestinal atresias, necrotizing enterocolitis (NEC), and midgut volvulus. For the multiple atresias, multiple anastomosis without resection has been successfully undertaken to avoid developing short gut syndrome for the last 17 years. For the massive involvement of the intestines due to NEC or volvulus, high jejunostomy and peritoneal drainage with TPN support have been tried for the last two patients and successfully weaned from the TPN within two months after closure of jejunostomy. However, in case 2 malabsorption has been persistent presumably due to a severe degree of mucosal damage occurring in the remaining intestines. Whether this eventually gets back to the normal or not is unknown. For the patients with short gut syndrome, small bowel reversal procedure was successfully done and now doing well 10 years after surgery. This paper reports details of these 3 cases.
Muraji
T
T
Department of Surgery, Kobe Children's Hospital, Japan.
Tsugawa
C
C
Nishijima
E
E
Ogasa
N
N
Sawamura
T
T
Matsumoto
Y
Y
Kimura
K
K
D004761:Enterocolitis, Pseudomembranous / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000601:surgery; D007421:Intestine, Small / Q000601:surgery*; D008286:Malabsorption Syndromes / Q000601:surgery*; D008297:Male; D012778:Short Bowel Syndrome / Q000601:surgery*