Thompson et al developed surgical guidelines for patients with the short bowel syndrome based on their experience with 160 patients. The authors are from the University of Nebraska in Omaha.
Parameters:
(1) bowel status
(2) length of small bowel segment
(3) total parenteral nutrition (TPN)
Bowel
Length
TPN
Procedure
dilated with stasis and/or overgrowth
> 120 cm
tapering or stricturoplasty
dilated
90 – 120 cm
tapering
dilated
60 – 90 cm
required
tapering with lengthening
normal diameter
not required (enteral sufficient)
no operation
rapid transit
> 90 cm
required
valve or reversed segment
normal diameter
60 – 90 cm
not given
< 60 cm
required but with complications
transplantation
after Figure 3, page 604
where:
• I added the entry for (a) dilated, 90-120 cm and (b) normal, 60-90 cm to fill a gap in diagram coverage.
If the ileocolonic junction (ileocecal valve) was absent, then a person with < 60 cm of small bowel is more likely to require long term TPN.
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