Abstract
The term short bowel syndrome (SBS) defines a state of maldigestion and malabsorption of many different etiologies. Pediatric SBS results after intrauterine loss or postnatal extensive resection of the small bowel or after trauma with mesenteric avulsion. The management is a significant challenge to the surgical and pediatric/gastroenterological team. New surgical strategies including autologous intestinal reconstruction techniques, or small bowel transplantation together with sophisticated nutritional therapeutic strategies, achieve significant improvement often with complete bowel rehabilitation. Nevertheless, even today some patients need additional long-term home parenteral nutrition for adequate physical development.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Beyer-Berjot L et al (2012) Segmental reversal of the small bowel can end permanent parenteral nutrition dependency: an experience in 38 adults with short bowel syndrome. Ann Surg 256:739–744
Bianchetti DGA et al (2018) D-lactic acidosis in humans: systemic literature review. Pediatr Nephrol 33:673–681
Bianchi A (1980) Intestinal loop lengthening – a technique for increasing small intestinal length. J Pediatr Surg 15:145–151
Bianchi A (1999) Experience with longitudinal intestinal lengthening and tailoring. Eur J Pediatr Surg 9:256–259
Bloom SR, Polak JM (1982) The hormonal pattern of intestinal adaptation. A major role for enteroglucagon. Scand J Gastroenterol 74:170–173
Bongaerts G, Severijnen R (2006) Arguments for lower carbohydrate-high fat diet in patients with a short small bowel. Medical Hypothesis 67:280–282
Brink MA et al (1996) Bilirubin cycles enterohepatically after ileal resection in the rat. Gastroenterology 110:1945–1957
Brubaker PL (2018) Glucagon-like peptide-2 and the regulation of intestinal growth and function. Compr Physiol 8:1185–1210
Bulik-Sullivan E et al (2018) Intestinal microbial and metabolic alterations following successful fecal microbiota transplant for D-lactic acidosis. JPGN 67:483–487
Capriati T et al (2018) Pediatric short bowel syndrome: predicting four-year outcome after massive neonatal resection. Eur J Pediatr Surg 28:455–463
Carter BA et al (2017) Outcomes from a 12-week, open label, multicenter clinical trial of teduglutide in pediatric short bowel syndrome. J Pediatr 181:102–111
Chiba M et al (2017) Markers on intestinal adaptation in pediatric short bowel syndrome. Pediatr Int 59:911–916
Crenn P et al (2008) Citrulline as a biomarker of intestinal failure due to enterocyte mass reduction. Clin Nutr 27:328–339
Cole CR et al (2008) Very low birth weight preterm infants with surgical short bowel syndrome: incidence, morbidity and mortality, and growth outcome at 18 to 22 month. Pediatrics 122:e573–e582
Colomb V et al (2007) Long-term outcome of children receiving home parenteral nutrition: A20-year single-center experience in 320 patients. JPGN 44:347–353
Dai Y-J et al (2016) Comparison of formulas based on lipid emulsions of olive oil, soyabean oil, or several oils for parenteral nutrition: a systematic review and meta-analysis. Adv Nutr 7:279–286
D’Antiga L, Goulet O (2013) Intestinal failure in children: the European view. J Pediatr Gastroenterol Nutr 56:118–126
Davidovics ZH et al (2017) Fecal transplantation successfully treats recurrent D-lactic acidosis in a child with short bowel syndrome. JPEN 41:896–897
Debongnie J, Phillips A (1978) Capacity of the human colon to absorb fluid. Gastroenterology 74:698–703
Demehri FR et al (2015) Enteral autonomy in pediatric short bowel syndrome: predictive factors one year after diagnosis. J Pediatr Surg 50:131–135
Diamanti A, Basso MS (2012) Colon and intestinal adaptation in children with short bowel syndrome. Letter to the editor. JPEN 36:501
Duggan CHP, Jaksic T (2017) Pediatric intestinal failure. N Engl J Med 377:666–675
Goulet O et al (2005) Outcome and long-term growth after extensive small bowel resection in the neonatal period. Eur J Pediatr Surg 15:95–101
Goulet O et al (2009) Role of the colon in short bowel syndrome and intestinal transplantation. JPGN 48(Suppl 2):S66–S71
Goulet O, Lambe C (2017) Intestinal lipid emulsions in pediatric patients with intestinal failure. Curr Opin Organ Transplant 22:142–148
Goulet O et al (2019) Short bowel syndrome as the leading cause of intestinal failure in early life: some insights into the management. Pediatr Gastroenterol Hepatol Nutr 22:303–329
Granger DN, Morris J, Kvietys PR (2018) Physiology and pathophysiology of digestion. In: Granger DN, Granger J (eds) Colloquium series on integrated physiology. Morgan & Claypool Life Sciences, San Rafael, CA
Grant C et al (2015) Human and mouse tissue-engineered small intestine both demonstrate digestive and absorptive function. Am J Physiol Gastrointest Liver Physiol 308(8):G664–G677
Greig CJ et al (2019) Retracing our STEPs: four decades of progress in intestinal lengthening procedures for short bowel. Am J Surg 217:772–782
Haxhija EQ et al (2008) Modulation of mouse intestinal cell turnover in the absence of angiotensin converting enzyme. Am J Physiol Gastrointest Liver Physiol 295:G88–G98
Hoellwarth ME et al (1988a) Pharmacologic enhancement of adaptive growth after extensive small bowel resection. Pediatr Surg Int 3:55–61
Hoellwarth ME et al (1988b) Blood flow in experimental short bowel syndrome. Pediatr Surg Int 4:242–246
Hoellwarth ME (2014) Short bowel syndrome in childhood. In: Granger DN, Granger J (eds) Colloquium series on integrated systems physiology. Morgan & Claypool Life Sciences
Hong CR et al (2019) Long-term outcomes of ultrashort bowel syndrome due to malrotation with midgut volvulus managed at an interdisciplinary pediatric intestinal rehabilitation center. J Pediatr Surg 54:964–967
Infantino BJ et al (2013) Successful rehabilitation in pediatric ultrashort small bowel syndrome. J Pediatr 163:1361–1366
Javid PJ et al (2018) Organization and outcomes of multidisciplinary intestinal failure teams. Semin Pediatri Surg 27:218–222
Jeejeebhoy NK (2008) Treatment of intestinal failure: transplantation or home parenteral nutrition. Editorial Gastroenterol 135:303–305
Jeppesen PB, Mortensen PB (1999) Colonic digestion and absorption of energy from carbohydrates and medium chain fat in small bowel failure. JPEN 23:S101–S105
Jeppesen PB et al (2018) Factors associated with response to teduglutide in patients with short-bowel syndrome and intestinal failure. Gastroenterology 154:874–885
Johnson LR (1976) The trophic action of gastrointestinal hormones. Gastroenterology 70:278–288
Joly F et al (2009) Morphological adaptation with preserved proliferation/transporter content in the colon of patients with short bowel syndrome. Am J Phys 297:G116–G123
Kim M-H, Kim H (2017) The role of glutamine in the intestine and its implication in intestinal diseases. Int J Mol Sci 18:1051. https://doi.org/10.3390/ijms18051051
Kono K et al (2001) Interposed colon between remnants of the small intestine exhibits small bowel features in patients with short bowel syndrome. Dig Surg 18:237–241
Lacaille F et al (2017) Twenty-eight years of intestinal transplantation in Paris: experience of the oldest European center. Transp Int 30:178–186
Lai SW et al (2017) Effects of exogeneous glucagon-like peptide-2 and distal bowel resection on intestinal and systemic adaptive response in rats. PLoS One 12(7):e0181453
Lloyd DA (1978) Colon interposition between jejunum and ileum after massive small bowel resection in rats. Prog Pediatr Surg 12:51–106
Mayr JM et al (1999) Morbidity and mortality of short bowel syndrome. Euro J Pediatr Surg 9:231–235
McMellen ME et al (2010) Growth factors: possible role for clinical management of the short bowel syndrome. Semin Pediatr Surg 19:35–43
Merras-Salmio L et al (2018) Pediatric intestinal failure: The key outcomes for the first 100 patients treated in a National Tertiary Referral Center during 1984–2017. JPEN 00:1–10
Merritt RJ et al (2017) Intestinal rehabilitation programs in the management of pediatric intestinal failure and short bowel. JPGN 65:588–596
Mughal M, Irving M (1986) Home parenteral nutrition in the united Kingdome and Ireland. Lancet 2:383–387
Naimi RM et al (2019) Effects of glepaglutide, a novel long-acting glucagon-like peptide 2 analogue, on markers of liver status in patients with short bowel syndrome: findings from a randomized phase 2 trial. EBioMedicine 46(444):451
Neelis E et al (2018) The gut microbiome in patients with intestinal failure: current evidence and implications for clinical practice. JPEN 00:1–12
Nordgaard I et al (1994) Colon as digestive organ in patients with short bowel. Lancet 343:373–376
Norgaard I et al (1996) Importance of colonic support for energy absorption as small-bowel failure proceeds. Am J Nutr 64:222–231
Olieman JF et al (2012a) Long-term impact of infantile short bowel syndrome on nutritional status and growth. Brit J Nutr 107:1479–1489
Olieman JF et al (2012b) Impact of infantile short bowel syndrome on long-term health-related quality of life: a cross-sectional study. J Pediatr Surg 47(1309):1316
O’Keefe SJD et al (2013) Safety and efficacy of teduglutide after 52 weeks of treatment in patients with short bowel intestinal failure. Clin Gastroenterol and Hepatol 11:815–823
Panis Y et al (1997) Segmental reversal of small bowel as an alternative to intestinal transplantation in patients with short bowel syndrome. Ann Surg 225:401–407
Peterson J, Kerner JA (2012) New advances in the management of children with intestinal failure. JPEN 36:S36–S42
Piper HG (2018) Intestinal microbiota in short bowel syndrome. Semin Pediatr Surg 27:223–228
Pironi L et al (2012) Outcome on home parenteral nutrition for benign intestinal failure: a review of the literature and benchmarking with the European prospective survey of ESPEN. Clin Nutrition 31:831–845
Potts WJ (1955) Pediatric surgery. JAMA 157:627–630
Pul M et al (1991) Enhancement by testosterone of adaptive growth after small bowel resection. Isr J Med Sci 27:339–342
Rickham PP (1967) Massive intestinal resection in newborn infants. Ann R Coll Surg 41:480–485
Salvia G et al (2008) Neonatal onset intestinal failure: an Italian multicenter study. J Pediatr 153:674–676
Schimpl G et al (1999) Bacterial translocation in short bowel syndrome in rats. Eur J Paediatr Surg 9:224–227
Shirafkan A et al (2016) New approaches to increase intestinal le ngth: method used for intestinal regeneration and bioengineering. World J Transplant 24:1–9
Sigalet D et al (2013) Nutritional support of infants with intestinal failure: something more than fishy is going on here. Pediatr Surg Int 29:975–981
Sigalet DL et al (2017) Safety and dosing study on glucagon-like peptide 2 in children with intestinal failure. JPEN 41:844–852
Smith A et al (2018) Laboratory monitoring of children on home parenteral nutrition: a prospective study. JPEN 42:148–155
Struijs M-C et al (2009) Establishing norms for intestinal length in children. J Pediatr Surg 44:933–938
Sukhotnik I et al (2002) Sandostatin impairs intestinal adaptation in a rat model of short bowel syndrome. Dig Dis Sci 47:2095–2102
Touloukian RJ, Walker-Smith GJ (1983) Normal intestinal length in preterm infants. J Pediatr Surg 6:720–723
Wales PW et al (2004) Neonatal short bowel syndrome: population-based estimates of incidence and mortality rates. J Pediatr Surg 39:690–695
Wiest R et al (2014) Pathological bacterial translocation in liver cirrhosis. J Hepatol 60:197–209
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Höllwarth, M.E. (2023). Short Bowel Syndrome. In: Puri, P., Höllwarth, M.E. (eds) Pediatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-81488-5_75
Download citation
DOI: https://doi.org/10.1007/978-3-030-81488-5_75
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-81487-8
Online ISBN: 978-3-030-81488-5
eBook Packages: MedicineMedicine (R0)