What is False about short bowel svndrome- and explain in detail?
Ans. is 'c' i.e., Hirsutism Short bowel syndrome -o Presence of less than 200 cm of residual small bowrel in adult patients.o Insufficient absorptive capacity of small intestine results in diarrhea, dehydration and malnutition.Causes - Small intestine resection (massive) due toMassive resection in singleCumutative effect of multipleoperation as in acute mesentericoperations of small intestineischemia, malignancyresected as in Crohn's diseaseo In pediatric patients, MC etiologies are intestinal atresia, volvulus and necrotizing enterocolitis. Resection of less than 50% of small intestine is generally well tolerated.o Clinically significant malabsorption occurs when more than 50 to 80% of small intestine has been resected.o Resection ofjejunum is better tolerated than resection of ileum.o Presence of healthy colon, intact ileocecal valve and healthy residual small bowel are factors associated with decreased severity of malabsorption.o Malabsorption in short bowel syndrome is exacerbated by a characteristic hypergastrinemia associated gastric acid hypersecretion which persists for 1 to 2 years post operatively.Management -1. Medical- a)TPNHigh dose H-, reseptor antagonist/PPLAntimotility agents - Loperamide.Octreotide - reduces volume of GI secretions.o Levels of Iron, Magnesium, Zinc, Copper and vitamins must be monitored closely and deficienc ies prevented.1 Surgery -Non transplant surgery : Goal is to increase nutrient and fluid absorption by slowing intestinal transit or increasing intestinal length.Segmental reversal of small bowel.Colon interpositionSmall intestinal valves construction.Electrical pacing of small intestine.Bianchi's Intestinal lengthening operation (generally used in pediatric patients with dilated small bowel).Serial transverse enteroplasty (2003).Intestinal transplantation : Indicated for life threatening complications of intestinal failure or chronic TPN therapy -Impending/overt liver failure.Thrombosis of major central veins.Frequent cathater related sepsis.Frequent episodes of severe dehydration.