Neonatal short bowel syndrome

Olivier J. Goulet, Yann Revillon, Dominique Jan, Sophie De Potter, Chantal Maurage, Stephen Lortat-Jacob, Hélène Martelli, Claire Nihoul-Fekete, Claude Ricour

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Abstract

In this retrospective study the management of infants who had undergoneresection of more than 50% of the small bowel as newborn infants between 1970 and 1988 was analyzed to define prognostic factors. Small bowel resections were performed for atresia (36 cases), volvulus (22 cases), gastroschisis (10 cases), necrotizing enterocolitis (11 cases), and other disorders (8 cases). Patients were classified into two groups depending on the length of residual small bowel: group 1 (n=35) had less than 40 cm of small bowel and group 2 (n=51) had 40 to 80 cm of residual small bowel. Patients in group 2 had significantly better survival rates than those in group 1 (92.0% vs 66.6%; p<0.001). The patients in group 1 who were born after 1980, when home parenteral nutrition was introduced, had better survival rates than those who were treated before 1980 (95.0% vs 65.0%; p<0.01). The time required for acquisition of intestinal adaptation depended on the intestinal length (average, 27.3 months for group 1 and 14 months for group 2; p<0.01) and on the presence or absence of the ileocecal valve. Parenteral or supportive enteral nutrition, or both, ensured normal growth in both groups. We conclude that more than 90% of infants now survive after extensive small bowel resection with parenteral nutrition and that the remaining small intestine will adapt with time. Home-based parenteral nutrition allowed children to be treated in the best psychosocial environment.

Original languageEnglish (US)
Pages (from-to)18-23
Number of pages6
JournalThe Journal of Pediatrics
Volume119
Issue number1 PART 1
DOIs
Publication statusPublished - Jul 1991
Externally publishedYes

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Goulet, O. J., Revillon, Y., Jan, D., De Potter, S., Maurage, C., Lortat-Jacob, S., ... Ricour, C. (1991). Neonatal short bowel syndrome. The Journal of Pediatrics, 119(1 PART 1), 18-23. https://doi.org/10.1016/S0022-3476(05)81032-7