Interposed colon between remnants of the small intestine exhibits small bowel features in a patient with short bowel syndrome.
We describe herein the case of a 48-year-old man who underwent emergency massive resection of the small intestine due to a strangulated ileus, which led to short bowel syndrome (SBS), as he was left with only 7 cm of jejunum and 8 cm of ileum with ileocecal valve. He then received interposition of a colon segment between the jejunum and ileum remnants isoperistaltically. For 24 months after the operation, he has been able to tolerate oral intake, but still requires partial home parenteral nutritional support during the night on a bimonthly basis. Biochemical and nutritional parameters, including the analysis of minerals and trace elements, indicated that the patient was in relatively good health. Histological examination revealed that the mucosa of the interposed colon showed hypertrophy and hyperplasia of the crypt glands, and cells resembling Paneth cells which are usually seen in the small intestine, suggesting that the colon segment exhibits adaptive changes to the small intestine. Colon interposition may be a useful technique in patients with SBS when the small bowel is too short for the other surgical considerations.
Kono
K
K
First Department of Surgery, Yamanashi Medical University, Yamanashi, Japan. kojikono@res.yamanashi-med.ac.jp
Sekikawa
T
T
Iizuka
H
H
Takahashi
A
A
Amemiya
H
H
Takehana
T
T
Ooi
A
A
Fujii
H
H
Matsumoto
Y
Y
D000714:Anastomosis, Surgical / Q000379:methods; D003106:Colon / Q000601:surgery*; D006801:Humans; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home; D010349:Patient Compliance; D012778:Short Bowel Syndrome / Q000209:etiology / Q000473:pathology* / Q000601:surgery*