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Enteral and parenteral nutrition in the short bowel syndrome in children

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Abstract

Thirteen children, aged 2 to 16 years, had a subtotal resection of small bowel, following a mid-gut volvulus in 10 cases. All children are alive, and their growth is normal; 36 cumulative patient-years of parenteral nutrition and 11 years of constant-rate enteral nutrition were performed. In 7 cases, in which residual small bowel varied between 30 to 120 cm, termination of all artificial nutritional support was possible 30 months in mean after intestinal resection. In contrast, if resection was near total with less than 20 cm remaining, life-long dependence on parenteral nutrition is unavoidable unless intestinal transplantation becomes feasible. With cyclic parenteral nutrition at home, the patients' quality of life is near normal.

Résumé

Treize enfants âgés de 2 à 16 ans ont subi une résection subtotale de l'intestin grêle dont 10 pour volvulus de sa partie moyenne. Tous ont survécu leur croissance s'étant effectuée normalement. Le total en années de la nutrition parentérale qu'ils ont reçu s'élève à 36 ans. Dans 7 cas, où la longueur du segment intestinal restant variait entre 30 et 120 cm, il fut possible d'arrêter l'alimentation parentérale 30 mois en moyenne après la résection. En revanche si la résection est quasi totale, la longueur du segment de grêle conservé étant inférieure à 20 cm, le maintien permanent de l'alimentation parentérale est inévitable à moins que la transplantation intestinale ne devienne possible. Grâce à l'alimentation parentérale organisée à domicile, la qualité de vie de ces sujets est presque normale.

Resumen

Trece niños de edades entre los 2 y los 16 años han sido sometidos a resección subtotal del intestino delgado, como consecuencia de vólvolus del intestino medio en 10 casos. Todos los niños se encuentran vivos y su crecimiento es normal; ellos representan 36 años-pacientes acumulados de nutrición parenteral y 11 años de nutrición enteral a tasa constante. En siete casos en quienes el intestino residual media entre 30 y 120 cm, fué posible terminar todo tipo de soporte nutricional artificial a los 30 meses, en promedio, después de realizada la resección intestinal. Por el contrario, si la resección fué casi total con menos de 20 cm de intestino residual, la dependencia vitalicia de nutrición parenteral es inevitable, a menos que el transplante intestinal llegue a ser factible. Mediante la nutrición parenteral cíclica realizada a domicilio, la calidad de la vida de estos pacientes llega a ser casi normal.

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Authors and Affiliations

  1. Department of Pediatrics, the Pediatric Gastroenterology and Nutrition Unit, Hôpital des Enfants Malades, Paris, France

    C. Ricour M.D., J. F. Duhamel M.D., F. Arnaud-Battandier M.D., Y. Couard M.D., Y. Revillon M.D. & C. Nihoul-Fekete M.D.

  2. Pediatric Surgery Unit, Hôpital des Enfants Malades, Paris, France

    C. Ricour M.D., J. F. Duhamel M.D., F. Arnaud-Battandier M.D., Y. Couard M.D., Y. Revillon M.D. & C. Nihoul-Fekete M.D.

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  1. C. Ricour M.D.
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  2. J. F. Duhamel M.D.
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  5. Y. Revillon M.D.
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  6. C. Nihoul-Fekete M.D.
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Ricour, C., Duhamel, J.F., Arnaud-Battandier, F. et al. Enteral and parenteral nutrition in the short bowel syndrome in children. World J. Surg. 9, 310–315 (1985). https://doi.org/10.1007/BF01656325

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