Digestion and absorption in a man with three feet of small intestine

A Useful Experimental Model of Short Bowel Syndrome

“…Flint [17] resected more than 70% of the intestine of dogs and found a duplication of the size of the cilium, which he interpreted as a quadruple increase of the area of absorptive surface. In 1939, West [18] demonstrated a hypertrophy in the residual intestine of a patient, who 2 years previously, had undergone a massive resection. Similar clinical findings were found by Althausen [19].…”

Short Bowel Syndrome

“…The data taken as a whole suggest that it is easier to meet the needs for energy and nitrogen by increasing oral intake than the needs for electrolytes and divalent ions. A review of the literature prior to the availability of parenteral nutrition shows that resections of up to 33% result in no malnutrition and those of up to 50% could be tolerated without special aids, but those in excess of 75% require nutritional support to avoid severe malnutrition [17][18][19][20][21][22][23][24][25][26][27].…”

Massive Intestinal Resection

“…Removal of large lengths of intestine is not lightly undertaken but cannot be avoided when the surgeon is faced with extensive gangrene. These resections, however extensive, are always worth while since there are many who not only survive but return to a tolerable life following resection of 80% to 90% of their small bowel (West et al, 1938;Todd et al, 1940;Holman, 1944;Meyer, 1946;Cogswell, 1948;Althausen et al, 1949;McClenahan and Fisher, 1950;Wilkie, 1950;Jackson and Linder, 1951;Berman et al, 1953;Martin et al, 1953;Bothe et al, 1954;Trafford, 1956;Pilling and Cresson, 1957). At the same time not all have fared so well.…”

“…Since then many reports show that life is possible with as little as 18 in. of small bowel, though Haymond's conclusions still provide a good working rule (West et al, 1938;Meyer, 1946;Cogswell, 1948;Althausen et al, 1949;Berman et al, 1950;Christensen et al, 1950;Berman et al, 1953;Pearce et al, 1953;Bothe et al, 1954;Eckstam and Barry, 1954;Jackson and Linder, 1955;Montgomery and Pincus, 1955;Schwartz et al, 1955;Trafford, 1956;Pilling and Cresson, 1957).…”