Overview of pediatric short bowel syndrome.

Division of Gastroenterology and Nutrition and Center for Advanced Intestinal Rehabilitation at Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
Journal of pediatric gastroenterology and nutrition (Impact Factor: 2.87). 09/2008; 47 Suppl 1:S33-6. DOI: 10.1097/MPG.0b013e3181819007
Source: PubMed

ABSTRACT Short bowel syndrome (SBS) is a malabsorptive state occuring as a result of surgical resection or congenital disease of a significant portion of the small intestine . The amount of resection or remaining bowel generally dictates the degree of malabsorption and consequentely the need for specialized enteral nutrition or parenteral nutrition (PN). Intestinal failure in the context of SBS is defined as a dependence on PN to maintain minimal energy and fluid requirement for growth in children. Common causes of SBS in infants and children include necrotizing enterocolitis, midgut volvulus, intestinal atresia, and gastroschisis. Early identification of patients at risk for long-term PN dependency is the first step toward avoiding severe complications. Close monitoring of nutritional status, steady and early introduction of enteral nutrition, and aggressive prevention, diagnosis, and treatment of infections such as central venous catheter sepsis and bacterial overgrowth can significantly improve the prognosis. Intestinal transplantation is an emerging treatment that may be considered when intestinal failure is irreversible and children are experiencing serious complications related to TPN administration.

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    • "SBS is a highly morbid disease, characterized by septic episodes, metabolic derangements, repeated hospitalizations, and a poor quality of life [6]. The care of children with SBS remains challenging, requiring meticulous management of PN and vigilance with regards to infectious complications [1] [7]. Counseling these patients and their families is made difficult by the relatively unpredictable course of the disease. "
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