Nutrient Management in a Patient with Severe Short Bowel Syndrome

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 25; no. 5; pp. 743 - 746
• Main Authors: Nishikawa, Noriko, Yoshikawa, Tomomichi, Sasaki, Kazuaki, Ohno, Kei, Hirata, Koichi, Takasaka, Hajime
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 2005; 日本腹部救急医学会
• Subjects: グルタミン; 上腸問膜動脈閉塞症; 短腸症候群; 短鎖脂肪酸
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem1993.25.743

A 67-year-old man was admitted to our hospital because of acute abdominal pain. We performed an emergency laparotomy under a diagnosis of acute abdomen. Extensive bowel necrosis caused by a mesenteric circulatory disturbance was found, and a broad resection including the small intestine and the right and transverse colon was performed. A primary anastomosis was performed because the remnant small intestine was too short to perform an ileostomy. Despite the presence of peritonitis, we were able to save the patient's life ; no severe complications, like ruptured sutures, occurred. The patient's residual small intestine was only about 10 cm in length, causing significant digestive malabsorption. The patient is presently receiving short-chain fatty acids and glutamine, administered as intestinal trophic factors, in an effort to improve intestinal digestive absorption. Patients with short bowels and digestive malabsorption may require additional therapeutic agents to wean them from TPN.