Severe Short-Bowel Syndrome in Children. Clinical Experience
| Autor: | J. Soler, María Canals, Emilio Fernández Álvarez, Juan José Vázquez, J. C. de Agustin, Dolores Rodríguez-Arnao |
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| Rok vydání: | 1999 |
| Předmět: |
Male
Short Bowel Syndrome medicine.medical_specialty medicine.medical_treatment Enteral administration Gastroenterology Internal medicine medicine Humans Child Omphalocele business.industry Gastroschisis Infant Newborn Infant Bowel resection medicine.disease Short bowel syndrome Transplantation Parenteral nutrition Child Preschool Growth Hormone Pediatrics Perinatology and Child Health Necrotizing enterocolitis Female Surgery Parenteral Nutrition Home business |
| Zdroj: | European Journal of Pediatric Surgery. 9:236-241 |
| ISSN: | 1439-359X 0939-7248 |
| DOI: | 10.1055/s-2008-1072252 |
| Popis: | INTRODUCTION Innovative surgical and pharmacological therapeutic measures in short-bowel syndrome (SBS) are constantly changing the prognosis of this devastating condition. The aim of this paper is to present our most recent experience in the treatment of this disease, with particular emphasis on the impact of home parenteral nutrition (HPN) and the use of growth hormone (GH). METHODS A group of 8 patients with severe SBS have been studied for the past 4 years. Intestinal length of less than 25% normal at the time of bowel resection was the criterion for inclusion in this study. RESULTS Mean age at the time of diagnosis was 2 years (ranging from 1 day to 9 years). The etiology of the SBS was Hirschsprung's disease (n = 3), midgut volvulus (n = 2), gastroschisis (n = 1), omphalocele with ileal atresia and necrotizing enterocolitis (n = 1) and Crohn's disease (n = 1). Length of the residual bowel was 8 and 50 cm with ileocecal valve (ICV) preservation and 23, 27, 30, 50, 70, 100 cm without ICV. Sixty percent of the patients survived. Two patients died due to fulminant gram-negative sepsis and one due to cardiac malformation. Two patients are still on parenteral nutrition (PN) providing 30 and 60% of total calories. Human GH (0.3 U/kg/day) was used in two patients over a period of 28 days. In these patients, an increased tolerance to enteral feeding was observed. HPN was provided in 5 cases, allowing regular school attendance in 3 patients. In 3 cases, discontinuation of the PN was achieved at 24, 25 and 35 months respectively. CONCLUSIONS Human GH can improve tolerance of enteral feeding. HPN has a beneficial effect on child behaviour. Intestinal transplantation must be considered when no other surgical or medical measures are available. |
| Databáze: | OpenAIRE |
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