Short bowel syndrome in infancy and childhood. Analysis of survival in 60 patients

Jay L. Grosfeld, Frederick Rescorla, Karen W. West

Research output: Contribution to journalArticle

106 Citations (Scopus)

Abstract

This report concerns 60 infants and children with short bowel syndrome, most commonly caused by necrotizing enterocolitis in this study. Resection of atretic or gangrenous bowel was performed in 53 patients, tapering enteroplasty and primary anastomosis was performed in 13 patients, and temporary enterostomies were performed in 40 patients. Second-look laparotomy was useful in two of four cases of questionable bowel viability. The ileocecal valve was resected in 33 patients and remained intact in 27. The mean length of remaining bowel was 58.4 cm (range 13 to 150 cm). Seven patients with total aganglionosis and mid to proximal small bowel extension were managed with an initial enterostomy, whereas three had a pull-through procedure with an aganglionic patch enteroplasty. All patients received total parenteral nutrition and early enteral feedings. Home hyperalimentation was attempted when 50 percent of the calorie intake was enteral. Intestinal adaptation required from 3 to 14 months. Frequent setbacks were related to catheter sepsis, rotavirus infection, carbohydrate intolerance, and liver dysfunction. The overall survival rate was 85 percent, with mortality due to liver failure and sepsis associated with total parenteral nutrition.

Original languageEnglish
Pages (from-to)41-46
Number of pages6
JournalAmerican Journal of Surgery
Volume151
Issue number1
DOIs
StatePublished - 1986
Externally publishedYes

Fingerprint

Short Bowel Syndrome
Survival Analysis
Enterostomy
Total Parenteral Nutrition
Sepsis
Ileocecal Valve
Rotavirus Infections
Necrotizing Enterocolitis
Liver Failure
Enteral Nutrition
Laparotomy
Small Intestine
Liver Diseases
Catheters
Survival Rate
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Short bowel syndrome in infancy and childhood. Analysis of survival in 60 patients. / Grosfeld, Jay L.; Rescorla, Frederick; West, Karen W.

In: American Journal of Surgery, Vol. 151, No. 1, 1986, p. 41-46.

Research output: Contribution to journalArticle

@article{cb68c651551f4d00af52faa82581999a,
title = "Short bowel syndrome in infancy and childhood. Analysis of survival in 60 patients",
abstract = "This report concerns 60 infants and children with short bowel syndrome, most commonly caused by necrotizing enterocolitis in this study. Resection of atretic or gangrenous bowel was performed in 53 patients, tapering enteroplasty and primary anastomosis was performed in 13 patients, and temporary enterostomies were performed in 40 patients. Second-look laparotomy was useful in two of four cases of questionable bowel viability. The ileocecal valve was resected in 33 patients and remained intact in 27. The mean length of remaining bowel was 58.4 cm (range 13 to 150 cm). Seven patients with total aganglionosis and mid to proximal small bowel extension were managed with an initial enterostomy, whereas three had a pull-through procedure with an aganglionic patch enteroplasty. All patients received total parenteral nutrition and early enteral feedings. Home hyperalimentation was attempted when 50 percent of the calorie intake was enteral. Intestinal adaptation required from 3 to 14 months. Frequent setbacks were related to catheter sepsis, rotavirus infection, carbohydrate intolerance, and liver dysfunction. The overall survival rate was 85 percent, with mortality due to liver failure and sepsis associated with total parenteral nutrition.",
author = "Grosfeld, {Jay L.} and Frederick Rescorla and West, {Karen W.}",
year = "1986",
doi = "10.1016/0002-9610(86)90009-7",
language = "English",
volume = "151",
pages = "41--46",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Short bowel syndrome in infancy and childhood. Analysis of survival in 60 patients

AU - Grosfeld, Jay L.

AU - Rescorla, Frederick

AU - West, Karen W.

PY - 1986

Y1 - 1986

N2 - This report concerns 60 infants and children with short bowel syndrome, most commonly caused by necrotizing enterocolitis in this study. Resection of atretic or gangrenous bowel was performed in 53 patients, tapering enteroplasty and primary anastomosis was performed in 13 patients, and temporary enterostomies were performed in 40 patients. Second-look laparotomy was useful in two of four cases of questionable bowel viability. The ileocecal valve was resected in 33 patients and remained intact in 27. The mean length of remaining bowel was 58.4 cm (range 13 to 150 cm). Seven patients with total aganglionosis and mid to proximal small bowel extension were managed with an initial enterostomy, whereas three had a pull-through procedure with an aganglionic patch enteroplasty. All patients received total parenteral nutrition and early enteral feedings. Home hyperalimentation was attempted when 50 percent of the calorie intake was enteral. Intestinal adaptation required from 3 to 14 months. Frequent setbacks were related to catheter sepsis, rotavirus infection, carbohydrate intolerance, and liver dysfunction. The overall survival rate was 85 percent, with mortality due to liver failure and sepsis associated with total parenteral nutrition.

AB - This report concerns 60 infants and children with short bowel syndrome, most commonly caused by necrotizing enterocolitis in this study. Resection of atretic or gangrenous bowel was performed in 53 patients, tapering enteroplasty and primary anastomosis was performed in 13 patients, and temporary enterostomies were performed in 40 patients. Second-look laparotomy was useful in two of four cases of questionable bowel viability. The ileocecal valve was resected in 33 patients and remained intact in 27. The mean length of remaining bowel was 58.4 cm (range 13 to 150 cm). Seven patients with total aganglionosis and mid to proximal small bowel extension were managed with an initial enterostomy, whereas three had a pull-through procedure with an aganglionic patch enteroplasty. All patients received total parenteral nutrition and early enteral feedings. Home hyperalimentation was attempted when 50 percent of the calorie intake was enteral. Intestinal adaptation required from 3 to 14 months. Frequent setbacks were related to catheter sepsis, rotavirus infection, carbohydrate intolerance, and liver dysfunction. The overall survival rate was 85 percent, with mortality due to liver failure and sepsis associated with total parenteral nutrition.

UR - http://www.scopus.com/inward/record.url?scp=0022613496&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0022613496&partnerID=8YFLogxK

U2 - 10.1016/0002-9610(86)90009-7

DO - 10.1016/0002-9610(86)90009-7

M3 - Article

C2 - 3080921

AN - SCOPUS:0022613496

VL - 151

SP - 41

EP - 46

JO - American Journal of Surgery

JF - American Journal of Surgery

SN - 0002-9610

IS - 1

ER -