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Short-Bowel Syndrome, Pediatric

Nina N. Sainath, MD, Christina B. Bales, MD and Judith Kelsen, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Malnutrition, malabsorption, and/or fluid and electrolyte loss after extensive small bowel resection 

PATHOPHYSIOLOGY

  • Markedly decreased mucosal surface area due to resection

  • Loss of tr...

DIAGNOSIS

HISTORY

  • Defecation pattern: number, size, nature (watery, bulky, foul smelling), presence of blood and mucous

  • Ostomy output: consistency (watery, viscous, thick), volume (≥50 mL/kg/24 h often ...

TREATMENT

MEDICATION

  • Supplementation of deficient vitamins (E, D, K, A, B12, folic acid)

  • Supplementation of deficient minerals (calcium, magnesium, iron, copper, selenium, and zinc)

  • H2-receptor antagonis...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • When to expect improvement: depends on site and extent of bowel resection

  • Signs to watch for:

    • Vomiting, diarrhea, weight loss, severe fluid and el...

ADDITIONAL READING

  • Cober PM, Killu G, Brattain A, et al. Intravenous fat emulsions reduction for patients with parenteral nutrition-associated liver disease. J Pediatr.  2012;160(3):421–427. [Vie...

CODES

ICD9

579.3 Other and unspecified postsurgical nonabsorption 

ICD10

K91.2 Postsurgical malabsorption, not elsewhere classified 

SNOMED

26629001 Short bowel syndrome (disorder) 

FAQ

  • Q: What are the favorable prognostic factors in short-bowel syndrome?

  • A: Greater length of residual small bowel, jejunal versus ileal resection, maintenance of the ICV, and lack of PNALD. Neonates ...

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