CandidateLong-Term Outcomes of Short Bowel Syndrome Requiring Long-Term/Home Intravenous Nutrition Compared in Children With Gastroschisis and Those With Volvulus
Section snippets
Patients and Methods
We examined the case records of all children discharged home on intravenous nutrition with short gut due to gastroschisis or volvulus aged 5 years and younger at the time of surgery. We reviewed the records of subjects presenting over a 10-year period from 1997 to 2007. Data were collected regarding the surgical procedure, the residual small bowel length, and the presence/absence of an ileo-cecal valve. Outcomes were assessed with regard to long-term intestinal failure as well as ability to be
Results
There were 13 children discharged home on PN treatment from 1997–2007. Nine (64%) were boys and 4 were girls. Patient details and outcomes are shown in Table 1.
Ten children with intestinal failure were on treatment with intravenous nutrition from the neonatal period. Two underwent intestinal resection, commencing intravenous nutrition treatment when aged 2 years, and 1 when 5 years old. SBS was secondary to extensive surgical resection for volvulus in 5 (38%), congenital short gut in 2 (15%),
Discussion
Children with gastroschisis who needed long-term/home intravenous feeding for months or years displayed worse outcomes than those aged 5 years and under at presentation with congenital or after intestinal resection for volvulus short gut. All infants and children with after intestinal resection for volvulus short gut and >10 cm small intestine successfully gained intestinal autonomy. The only deaths were in the group with gastroschisis.
The outcomes for infants and children with severe
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