title: Clinical problem-solving: Short bowel syndrome in an infant.
abstract: The present case report describes the clinical problems encountered over a five-month period in an infant born with jejunal atresia, extensive midgut volvulus and a microcolon. After an initial surgical resection, the patient had no remaining ileum and his ileocecal valve was also removed. The patient had 35 cm of jejunum, which was successfully lengthened to 60 cm using enteral nutrition and two bowel-lengthening procedures (serial transverse enteropathy procedures). Bouts of cholestatic liver disease, sepsis and small bowel bacterial overgrowth were vigorously treated. The patient was discharged at 5.5 months of age and is now 40 months of age. He is at the 50th percentile for both height and weight, and is developing normally. The outcome for infants with short bowel syndrome has improved significantly in the past few years due to intestinal rehabilitation programs, which integrate nutritional, surgical and pharmacological approaches tailored to individual needs.
authors.affiliation: Services de gastroentérologie, hépatologie et nutrition, Département de pédiatrie, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Quebec.
authors.forename: Claude C
authors.initials: CC
authors.lastname: Roy
authors.affiliation: Services de gastroentérologie, hépatologie et nutrition, Département de pédiatrie, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Quebec.
authors.forename: Véronique
authors.initials: V
authors.lastname: Groleau
authors.affiliation: Service de chirurgie générale, Département de Chirurgie, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Quebec.
authors.forename: Mona
authors.initials: M
authors.lastname: Beaunoyer
authors.affiliation: Services de gastroentérologie, hépatologie et nutrition, Département de pédiatrie, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Quebec.
authors.forename: Valérie
authors.initials: V
authors.lastname: Marchand
keywords: Enteral nutrition; Infant; Intestinal failure; Parenteral nutrition; Serial transverse enteroplasty procedure; Short bowel syndrome