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.
(1) bowel status
(2) length of small bowel segment
(3) total parenteral nutrition (TPN)
dilated with stasis and/or overgrowth
> 120 cm
tapering or stricturoplasty
90 – 120 cm
60 – 90 cm
tapering with lengthening
not required (enteral sufficient)
> 90 cm
valve or reversed segment
< 60 cm
required but with complications
after Figure 3, page 604
• 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.
To read more or access our algorithms and calculators, please log in or register.
Specialty: Nutrition, Surgery, general, Gastroenterology