Complications in neonates with short bowel syndrome and long-term parenteral nutrition.
BACKGROUND
Because of advances in parenteral nutrition (PN), the prognosis for patients with short bowel syndrome (SBS) has recently shown great improvement. Even infants with a small bowel measuring only 20 cm either with or without an ileocoecal valve can now survive. However, because of the increased periods of PN, severe complications associated with PN have been observed.


METHODS
We analyzed 17 patients with SBS treated by long-term PN to investigate the complications of PN, particularly hepatic dysfunction, micronutrient deficiency, and intoxication.


RESULTS
Eleven of 17 patients (64.7%) had hepatic dysfunction, mostly cholestasis. The main causes of hepatic dysfunction were loss of enteral feeding and infections. Regarding the complications of the micronutrients, zinc and copper deficiencies have been observed less often because of trace element supplements. However, manganese deposition, especially in the basal ganglia, was recognized in one patient.


CONCLUSIONS
We therefore need to pay more attention to these problems when treating this disease in order to improve the overall prognosis significantly.
Suita
S
S
Department of Pediatric Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Masumoto
K
K
Yamanouchi
T
T
Nagano
M
M
Nakamura
M
M
D002779:Cholestasis / Q000150:complications* / Q000209:etiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009751:Nutritional Requirements; D010288:Parenteral Nutrition / Q000009:adverse effects*; D011379:Prognosis; D012778:Short Bowel Syndrome / Q000145:classification / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D014131:Trace Elements / Q000172:deficiency
D014131:Trace Elements