Improvement in the quality of life using both Bianchi’s procedure and the closure of a jejunostomy in a case with short bowel syndrome

Abstract

In cases with short bowel syndrome (SBS), intestinal adaptation often requires a long time. In addition, the quality of life in SBS is not especially good due to some complications, including growth impairment, severe diarrhea, complications of parenteral nutrition (PN), and so on. We herein report an adolescent boy with SBS secondary to midgut volvulus. He suffered mainly from both severe high output syndrome, which caused a large amount of enteric fluid to flow out from the jejunostomy, and growth impairment, although PN continued after the occurrence of SBS. As a result, he thereafter could not continue his daily school life. Therefore, he was introduced to our department at 6 months after the operation. A closure of the jejunostomy combined with longitudinal intestinal lengthening using Bianchi's procedure was performed. Thereafter, the above-described symptoms disappeared. He was discharged and thereafter was again able to attend school with an improvement in his growth within 2 months after the second operation. Home PN was discontinued at 15 months after the second operation. Based on our experience, in cases of SBS without intestinal functional disorder, an early closure of the jejunostomy combined with Bianchi's procedure might therefore possibly lead to an early improvement in the complications related to SBS.

Intensive care and the surgical treatment children with the short bowel syndrome (review)

“…Якомога раннє відновлення цілісності кишечника дозволяє усім залишеним сегментам кишки брати участь у процесах травлення та абсорбції, що, у свою чергу, стимулює процеси кишкової адаптації. Раннє закриття стоми, зокрема при завороті або некротичному ентероколіті, є важливим компонентом лікування [62,78]. Окрім того, раннє закриття стоми асоціюється зі швидким досягненням незалежності від парентерального харчування [5].…”

“…Відносно оптимального віку дитини, коли необхідно проводити реконструктивне втручання, узгоджені рекомендації у літературі відсутні. Ці операції виконують як у неонатальному періоді [25], так і у підлітковому віці [58,62]. Водночас, за даними S.J.…”