title: More on 'No Gut Syndrome': A case report.
abstract: BACKGROUND
  No Gut Syndrome refers to a condition which results after a near total enterectomy (NTE) has been performed. These patients are unable to sustain life without life-long parenteral nutrition (PN). Re-establishment of bowel continuity, complications, quality of life (QoL), and overall outcomes are important aspects to be considered in patients who might need a NTE. We have previously reported two similar cases as well as a literature review in patients with No Gut Syndrome. In the present report, we present an additional case and an update of the literature.
  
  
  METHODS
  A 62-year old man with multiple co-morbidities presented with features of acute small bowel obstruction. Exploratory laparotomy revealed severe mesenteric ischemia and extensive small bowel necrosis. Patient eventually underwent a NTE and was discharged on parenteral nutrition.
  
  
  CONCLUSIONS
  Near total enterectomy (NTE) is a clinical condition in which a patient is left without or with minimal length of small bowel along with either gastrointestinal continuity or exteriorization of the proximal end. This condition has remained a dilemma for surgeons worldwide chiefly as a result of its perceived incompatibility with life. There are only a few available options for proceeding with treatment, however maintenance on long term parenteral nutrition has shown promising results.
  
  
  CONCLUSIONS
  Long term parenteral nutrition serves as a viable treatment option for managing patients after a NTE.
authors.affiliation: Maulana Azad Medical College and Lok Nayak Hospital, University of Delhi, Delhi 110002, India. Electronic address: varunjain7@hotmail.com.
authors.forename: Varun
authors.initials: V
authors.lastname: Jain
authors.affiliation: University of Texas Southwestern Medical Center, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX 75216, United States.
authors.forename: Sergio
authors.initials: S
authors.lastname: Huerta
keywords: Extensive bowel necrosis; Near total enterectomy; Severe mesenteric ischemia; Short bowel syndrome; Total parenteral nutrition