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.
Specialty: Nutrition, Surgery, general, Gastroenterology