Ultrashort Bowel Syndrome: long-term survival without Parenteral Nutrition

Abstract

Short Bowel Syndrome (SBS) is a condition in which nutrients are not absorbed (malabsorption) because a large part of the small intestine is missing or has been surgically removed, developing an Intestinal Failure (IF), that is defined as a loss of absorptive capacity secondary to obstruction, dysmotility, surgical resection, congenital defect, or mucosal disease resulting in chronic diarrhea, dehydration, electrolyte abnormalities, micronutrient imbalance, and malnutrition. The long-term survival without parenteral nutrition in patients with the diagnosis of ultrashort bowel syndrome is difficult. his is a case, first reported in the country, of a 63 years old woman with ultrashort bowel syndrome who after three abdominal surgeries was left with only about 35 cm of small intestine with a jejune-transverse anastomosis. During the first surgery the right colon was removed. From the beginning she received Total Parenteral Nutrition (TPN) lasting about three months, at which time she presented a serious reaction after which she refused further TPN treatment. She lived with oral feeding including nutritional supplements for almost five years, and one significant complication,diarrhea, was managed with loperamida and octreotride.