title: [Age-dependent visceral medicine: paediatric visceral medicine - visceral medical paediatrics - considerations on the short bowel syndrome in childhood].
abstract: There are several reasons for the possible development of a short bowel syndrome, which, however, occurs only rarely. The main causes consist of extended intestinal resections in cases of congenital anomalies (e.g., gastroschisis, intestinal atresia or dysplasia) or ischaemic lesions due to a volvulus. In addition, an intestinal stoma at a more upper segment of the GI tract can result in the functional manifestation of a short bowel syndrome. The differentiation between temporary and persisting types is essential for initiation of an adequate treatment. Loss or exclusion of organic resorption area at the inner surface of the (small) intestine can be associated with numerous pathological consequences requiring treatment. As a principle consideration from the paediatric point of view, the potential of intestinal adaptation needs to be assessed. Basic conservative treatment options are parenteral and enteral nutrition regimens, in particular, to prevent complications (such as D-lactate acidosis). The main surgical approaches are the procedures called LILT (longitudinal intestinal lengthening and tailoring) according to Bianchi and STEP (serial transverse enteroplasty). The technique to create intestinal segments of antiperistalsis has been abandoned. Because of the encouraging results of intestinal transplantation, this novel treatment option has gained greater attention over the past few years and is now also an option for paediatric patients. The limiting factor and thus major complication is the central venous catheter for long-term treatment. Catheter-related complications are still the main reason for a considerable mortality in these children.
authors.affiliation: Arbeitsbereich Kinderchirurgie, Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland. hardy.krause@med.ovgu.de
authors.forename: H
authors.initials: H
authors.lastname: Krause
authors.forename: M
authors.initials: M
authors.lastname: Heiduk
authors.forename: R
authors.initials: R
authors.lastname: Wachowiak
authors.forename: H
authors.initials: H
authors.lastname: Till
mesh_terms: D000367:Age Factors; D002405:Catheterization, Central Venous; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000601:surgery*; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000601:surgery; D041981:Gastrointestinal Tract / Q000002:abnormalities* / Q000601:surgery*; D020139:Gastroschisis / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007081:Ileostomy; D007223:Infant; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000175:diagnosis / Q000601:surgery; D007422:Intestines / Q000637:transplantation; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D012778:Short Bowel Syndrome / Q000209:etiology*