Comparison of short bowel syndrome acquired early in life and during adolescence

Matias Bruzoni, Debra L. Sudan, Robert A Cusick, Jon S Thompson

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

BACKGROUND.: Prolonged survival in pediatric patients with short bowel syndrome (SBS) is now possible because of parenteral nutrition and small bowel transplantation. We hypothesized that there may be important differences between adult patients who developed SBS during early childhood and those who develop this as adolescents. METHODS.: Sixty-seven patients between the ages of 16 and 40 years were studied. Thirty patients developing SBS younger than 12 years comprised the pediatric group (PG), 37 developing SBS at age 13 to 25 constituted the adolescent group (AG). RESULTS.: Midgut volvulus (n=11) was the most common cause in the PG followed by gastroschisis (n=5), intestinal atresia (n=5), and necrotizing enterocolitis (n=4). The most common cause of SBS in the AG was trauma (n=13), followed by tumors (n=7) and postoperative complications (n=5). A similar portion in each group had intestinal remnants less than 60 cm (69% vs. 58%), however, the PG was more likely to have a colon remnant (97% vs. 71%, P<0.05), and less likely to have an ostomy (7% vs. 47%, P<0.05). Patients in PG were followed significantly longer than AG (246±67 vs. 90±58 months, P<0.05). A similar portion of the patients require long-term parenteral nutrition (86% vs. 84%) or have undergone intestinal transplant (28% vs. 23%). Significantly more pediatric patients had negative height z scores when compared with the adolescents. CONCLUSIONS.: Acknowledging the inherent biases created in defining the two groups, pediatric patients developing SBS early in life seem to be similar to those who develop SBS as adolescents with regards to long-term outcome, despite differences in origin and intestinal anatomy.

Original languageEnglish (US)
Pages (from-to)63-66
Number of pages4
JournalTransplantation
Volume86
Issue number1
DOIs
StatePublished - Jul 15 2008

Fingerprint

Short Bowel Syndrome
Pediatrics
Parenteral Nutrition
Intestinal Atresia
Ostomy
Gastroschisis
Necrotizing Enterocolitis
Anatomy
Colon
Transplantation
Transplants
Survival
Wounds and Injuries

Keywords

  • Intestinal failure
  • Intestinal transplantation
  • Short bowel syndrome
  • Total parenteral nutrition

ASJC Scopus subject areas

  • Transplantation

Cite this

Comparison of short bowel syndrome acquired early in life and during adolescence. / Bruzoni, Matias; Sudan, Debra L.; Cusick, Robert A; Thompson, Jon S.

In: Transplantation, Vol. 86, No. 1, 15.07.2008, p. 63-66.

Research output: Contribution to journalArticle

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N2 - BACKGROUND.: Prolonged survival in pediatric patients with short bowel syndrome (SBS) is now possible because of parenteral nutrition and small bowel transplantation. We hypothesized that there may be important differences between adult patients who developed SBS during early childhood and those who develop this as adolescents. METHODS.: Sixty-seven patients between the ages of 16 and 40 years were studied. Thirty patients developing SBS younger than 12 years comprised the pediatric group (PG), 37 developing SBS at age 13 to 25 constituted the adolescent group (AG). RESULTS.: Midgut volvulus (n=11) was the most common cause in the PG followed by gastroschisis (n=5), intestinal atresia (n=5), and necrotizing enterocolitis (n=4). The most common cause of SBS in the AG was trauma (n=13), followed by tumors (n=7) and postoperative complications (n=5). A similar portion in each group had intestinal remnants less than 60 cm (69% vs. 58%), however, the PG was more likely to have a colon remnant (97% vs. 71%, P<0.05), and less likely to have an ostomy (7% vs. 47%, P<0.05). Patients in PG were followed significantly longer than AG (246±67 vs. 90±58 months, P<0.05). A similar portion of the patients require long-term parenteral nutrition (86% vs. 84%) or have undergone intestinal transplant (28% vs. 23%). Significantly more pediatric patients had negative height z scores when compared with the adolescents. CONCLUSIONS.: Acknowledging the inherent biases created in defining the two groups, pediatric patients developing SBS early in life seem to be similar to those who develop SBS as adolescents with regards to long-term outcome, despite differences in origin and intestinal anatomy.

AB - BACKGROUND.: Prolonged survival in pediatric patients with short bowel syndrome (SBS) is now possible because of parenteral nutrition and small bowel transplantation. We hypothesized that there may be important differences between adult patients who developed SBS during early childhood and those who develop this as adolescents. METHODS.: Sixty-seven patients between the ages of 16 and 40 years were studied. Thirty patients developing SBS younger than 12 years comprised the pediatric group (PG), 37 developing SBS at age 13 to 25 constituted the adolescent group (AG). RESULTS.: Midgut volvulus (n=11) was the most common cause in the PG followed by gastroschisis (n=5), intestinal atresia (n=5), and necrotizing enterocolitis (n=4). The most common cause of SBS in the AG was trauma (n=13), followed by tumors (n=7) and postoperative complications (n=5). A similar portion in each group had intestinal remnants less than 60 cm (69% vs. 58%), however, the PG was more likely to have a colon remnant (97% vs. 71%, P<0.05), and less likely to have an ostomy (7% vs. 47%, P<0.05). Patients in PG were followed significantly longer than AG (246±67 vs. 90±58 months, P<0.05). A similar portion of the patients require long-term parenteral nutrition (86% vs. 84%) or have undergone intestinal transplant (28% vs. 23%). Significantly more pediatric patients had negative height z scores when compared with the adolescents. CONCLUSIONS.: Acknowledging the inherent biases created in defining the two groups, pediatric patients developing SBS early in life seem to be similar to those who develop SBS as adolescents with regards to long-term outcome, despite differences in origin and intestinal anatomy.

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