Abstract
We present a 50-year-old male who suffered from ischemic bowel disease, having undergone massive resection of small intestine and ileocecal valve. He had to cope with 40 cm proximal jejunum and 70 cm distal colon remaining. In the postoperative period parenteral nutrition (PN) was used immediately for nutrition support and electrolyte imbalance correction. We gave him home PN as regular recommendation for the short bowel status after discharge from hospital. This patient has tolerated regular oral intake 2 months later and did not develop significant short bowel syndrome. There were several episodes of venous access infection which troubled this patient and admitted him for treatment during home PN. Therefore, we changed home PN to cyclic tapering pattern. The patient could maintain his nutrition and hydration with oral intake alone after tapering home PN 15 months later. He has survived more than one year without PN support and still maintained 80% ideal body weight with average albumin of 3.5 ± 0.2 mg/dL. Although patient was hospitalized every two months to supplement nutrients, however, this has greatly improved the quality of life.
Highlights
Resection of large portion of the small bowel may cause severe malabsorption, malnutrition, and electrolyte imbalance [1, 2]
The minimal absorptive area of small intestine to sustain life varies from individual to individual
We have evaluated the nutritional status and assured the efficient protein absorption despite the relatively short small intestine
Summary
Resection of large portion of the small bowel may cause severe malabsorption, malnutrition, and electrolyte imbalance [1, 2]. The outcomes of the resection depend on the amount of intestine left and the specific section resected and preservation of colonic length or the presence of the ileocecal valve [1]. After immediate postoperative care, keeping the patient alive through the use of parenteral nutrition (PN) and antisecretory agents [3] and promoting gut adaptation by oral nutrition were commonly used [4]. The minimal absorptive area of small intestine to sustain life varies from individual to individual
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