1 / 7

Short Bowel Syndrome

Short Bowel Syndrome. Dr. TAMER M. ABD ELRHMAN. Short Bowel Syndrome. Presence of less than 200cm of residual small bowel in adult . Functional definition: - insufficient intestinal absorptive capacity results in: Diarrhea. Dehydration. Malnutrition. . AETIOLOGY. In adult:

feng
Download Presentation

Short Bowel Syndrome

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Short Bowel Syndrome Dr. TAMER M. ABD ELRHMAN

  2. Short Bowel Syndrome • Presence of less than 200cm of residual small bowel in adult. • Functional definition: - insufficient intestinal absorptive capacity results in: • Diarrhea. • Dehydration. • Malnutrition.

  3. AETIOLOGY In adult: • Acute mesenteric ischemia • radiation enteritis • Malignancy • Crohn’s disease In pediatric: • Intestinal atresias • Volvulus • Necrotizing enterocolitis

  4. PATHOPHYSIOLOGY • Presence or absence of an intact colon (capacity to absorb fluid & electrolytes and absorb short-chain FA). • Intact ileo-cecal valve. • A healthy, rather diseased residual small intestine is associated with decreased severity of malabsorption. • Resection of jejunum is better tolerated than the ileum, due to bile salt and vit. B12 absorption capacity of the ileum.

  5. MEDICAL THERAPY: • Management of primary condition causing intestinal resection • Correct fluid & electrolyte imbalance. • TPN, enteral nutrition is gradually introduced. • H2 receptor antagonist --> to reduce gastric acid secretion. • Antimotility agents (loperamideHCL). • Octreotide to reduce volume of gastrointestinal secretion.

  6. SURGICAL THERAPY Goal is to increase nutrient and fluid absorption by slowing intestinal transit or increasing intestinal length • Slow intestinal transit: • Segmental reversal of the small bowel. • Interposition of a segment of colon. • Construction of small intestinal valves. • Electrical pacing of the small bowel. • Intestinal lengthening operation: Serial transverse enteroplasty procedure.

  7. SURGICAL THERAPY Intestinal transplant: Indicated in presence of life threatening complication attributed to intestinal failure or long term TPN therapy.

More Related