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Epidemiology, management and outcome of ultrashort bowel syndrome in infancy
  1. Akshay Batra1,
  2. Simon Charlie Keys2,
  3. Mark John Johnson3,
  4. Robert A Wheeler2,
  5. Robert Mark Beattie1
  1. 1Department of Paediatric Gastroenterology, Southampton Children’s Hospital, Southampton, UK
  2. 2Wessex Regional Pediatric Surgery, Southampton Children’s Hospital, Southampton, UK
  3. 3Department of Neonatal Medicine, Southampton Children’s Hospital, Southampton, UK
  1. Correspondence to Professor Robert Mark Beattie, Department of Paediatric Gastroenterology, Southampton Children’s Hospital, University Hospital Southampton, Tremona road, Southampton, SO16 6YD, UK; rm.beattie{at}btinternet.com

Abstract

Ultrashort bowel syndrome (USBS) is a group of heterogeneous disorders where the length of small bowel is less than 10 cm or 10% of expected for the age. It is caused by massive loss of the gut which in the neonatal period can be a result of vanishing gastroschisis or surgical resection following mid-gut volvulus, jejunoileal atresia and/or extensive necrotising enterocolitis. The exact prevalence of USBS is not known although there is a clear trend towards increasing numbers because of increased incidence and improved survival. Long-term parenteral nutrition (PN) is the mainstay of treatment and is best delivered by a multidisciplinary intestinal rehabilitation team. Promoting adaptation is vital to improving long-term survival and can be achieved by optimising feeds, reducing intestinal failure liver disease and catheter-related bloodstream infections. Surgical techniques that can promote enteral tolerance and hence improve outcome include establishing intestinal continuity and bowel lengthening procedures. The outcome for USBS is similar to patients with intestinal failure due to other causes and only a small proportion of children who develop irreversible complications of PN and will need intestinal transplantation. In this review, we will summarise the available evidence focusing particularly on the epidemiology, management strategies and outcome.

  • ultrashort bowel syndrome
  • infancy
  • intestinal failure

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors AB and RMB conceived the article. All of the authors contributed to the article and approved the final version.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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