Short Bowel Syndrome and Malabsorption - Causes and Prevention.
BACKGROUND
The short bowel syndrome (SBS) is a condition caused by extensive intestinal resection for a variety of conditions. The etiology varies by age group. Necrotizing enterocolitis is the leading cause in infants. In older children, trauma and malignancies are most common. Postoperative SBS has become most common in adults, followed by mesenteric vascular disease and cancer/irradiation.


METHODS
Systematic literature review.


RESULTS
Prevention of SBS should be given high priority. Each of the etiologies has been evaluated and strategies to prevent extensive resection have been developed. These include a thoughtful approach to reoperation, early identification of complications, e.g. intestinal ischemia, reducing radiation enteritis, and bowel-conserving therapies in diseases such as Crohn's disease.


CONCLUSIONS
Several operative strategies to prevent SBS are useful. Timing and extent of reoperation need careful consideration. Minimizing intestinal resection, bowel-conserving techniques for complications such as fistula or strictures, and remodeling procedures are important.
Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Jon S
JS
Thompson
Crohn's disease; Radiation enteritis; Short bowel syndrome