Parenteral nutrition independence in a patient left with 25 cm of ileum and jejunum: a case report.
A 44-year-old woman with a history of Roux-en-Y gastric bypass (RYGBP) suffered small bowel volvulus. She was left post-operatively with an intact duodenum, 25 cm of jejunum and ileum, and a colon in continuity, a situation synonymous to short bowel syndrome. This report describes her surgical, medical and nutritional follow-up until complete weaning of parenteral nutrition despite of her very short remnant small bowel and persistently low citrullinemia. The discussion aims at demonstrating the rarity of these complications after RYGBP according to the literature. Furthermore, it challenges the validity of the present markers of parenteral nutrition independence (remnant small bowel length, citrullinemia) in case of short bowel syndrome.
Genton
Laurence
L
Clinical Nutrition, Geneva University Hospital, Rue Gabrille-Perret-Gentil 4, 1211 Geneva 14, Switzerland.
Nardo
Patrizia
P
Huber
Olivier
O
Pichard
Claude
C
D000328:Adult; D020159:Citrullinemia / Q000209:etiology* / Q000628:therapy; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007082:Ileum / Q000601:surgery*; D045822:Intestinal Volvulus; D007583:Jejunum / Q000601:surgery*; D010288:Parenteral Nutrition / Q000379:methods*; D012778:Short Bowel Syndrome / Q000150:complications*; D016896:Treatment Outcome