Massive Resection of the Small Intestine after Occlusion of the Superior Mesenteric Artery

Harrison, R. J.; Booth, C. C.

doi:10.1136/gut.1.3.237

Cited by 15 publications

(5 citation statements)

References 13 publications

(4 reference statements)

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“…Furthermore, in patients with intestinal resection, there may be other changes in hepatocellular function associated with mild to moderate fatty change in the liver. In previous case reports of patients with extensive small bowel resection, fatty liver, with or without hepatic atrophy (Doolan, Kyle, Hess, and Phelps, 1951;Linder, Jackson, and Linder, 1953;Martin, Pattee, Gardner, and Marien, 1953;Arends, Nieweg, and Engelhardt, 1954;Harrison and Booth, 1960;Levin, Zamcheck, and Gottlieb, 1961), increased BSP retention (Jarnum, Schwartz, Thing, and Thorsoe, 1961), and evidence of hepatocellular dysfunction (Kositchek and Rabwin, 1950;Chodoff, 1950;Jackson, Linder, and Berman, 1951;Jarnum et al, 1961;Heaton, 1965;Windsor, Fejfar, and Woodward, 1969) have all been described. However, many of these patients died from cachexia as a result of postresection malabsorption and the fatty change.…”

Section: Discussionmentioning

confidence: 97%

Liver structure and function following small bowel resection

Gupta¹,

Neale²,

Dowling³

1973

Gut

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SUMMARY The observation that patients with extensive small bowel resection have impaired hepatocellular function with reduced BSP clearance and fatty change in biopsies from the liver led to a systematic study of liver structure and function following proximal and distal small bowel resection in the rat.While anaesthesia and surgery impaired BSP clearance per se, small bowel resection further reduced BSP clearance with impairment of both uptake and excretion phases of BSP excretion.The increased BSP retention was more marked after distal than after proximal small bowel resection, but in both experimental groups the abnormalities of BSP excretion spontaneously returned to normal three to four weeks after surgery.Circulating liver enzymes were normal but serum alkaline phosphatase was significantly depressed, particularly after distal resection. Isoenzyme studies showed that the depression of serum AP was due to a reduced intestinal isoenzyme. While serum levels remained consistently depressed up to eight weeks after proximal resection, in parallel with mucosal regeneration, serum AP returned to normal two to four weeks after ileectomy.While these minor changes in hepatic structure and function would normally be of little clinical importance, the additional insult of hepatic dysfunction may well be important in malnourished patients after extensive small bowel resection.

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Section: Discussionmentioning

confidence: 97%

Liver structure and function following small bowel resection

Gupta¹,

Neale²,

Dowling³

1973

Gut

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“…Whether the remaining small-bowel mucosa hypertrophies and the bowel dilates or elongates has been the subject of debate, with evidence put forward for both positive and negative viewpoints (Harrison and Booth, 1960). Much earlier, Flint (1912) suggested that the villi proliferated, and Clatworthy, Saleeby, and Lovingood (1952) found hypertrophy and dilatation in experimental puppies.…”

Section: Discussionmentioning

confidence: 99%

“…Booth et al (1963) have drawn attention to the importance of magnesium losses in patients with chronic steatorrhoea and diarrhoea, and Hanna et al (1960) have described mental changes and even convulsions in cases with severe magnesium deficiency. Harrison and Booth (1960) suggest that a large excretion of fat in the stools encourages magnesium losses as magnesium soaps, and that a low-fat diet is advantageous. However, the patient would not keep to a low-fat diet for any length of' time owing to its unpalatability and lack of hunger satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Long-term Survival with Six Inches of Small Intestine

Anderson¹

1965

BMJ

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“…Before the discovery of PN in the 1960s patients would die from starvation caused by chronic malnutrition 6. During the 1970s and 1980s clinicians in the USA started to provide parenteral nutrition at home to adults who suffered chronic IF due to non-malignant diseases 8.…”

Section: Introductionmentioning

confidence: 99%