Short bowel syndrome and crohn's disease

Jon S Thompson, Kishore R. Iyer, John K. Dibaise, Renee L. Young, Cindy R. Brown, Alan Norman Langnas

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Patients with Crohn's disease are at high risk for recurrent disease and often undergo multiple operations. Our aims were to evaluate surgical management and outcome of patients with Crohn's disease who develop short bowel syndrome (SBS) and to identify factors leading to this complication. We reviewed the records of 170 adult patients with SBS evaluated over a 20-year period. Thirty (18%) had Crohn's disease. SBS was defined as an intestinal remnant less than 180 cm with associated malabsorption. There were 20 women and 10 men ranging in age from 18 to 62 years. Eighteen (60%) presented initially with ileocolonic disease, seven (23%) with colonic disease, and five (17%) with small intestinal disease. The interval from initial diagnosis to development of SBS ranged from 2 to 32 years, with 21 patients (71%) having an interval greater than 15 years. The number of resections leading to SBS varied from 2 to 12 with 24 patients (80%) having four or fewer resections. Nineteen patients (63%) had an ostomy. Small intestinal remnant length was less than 60 cm in 10 patients, 60 to 120 cm in six patients, and greater than 120 cm in 14 patients. Only one patient underwent stricturoplasty before developing SBS. Five patients were initially diagnosed as having ulcerative colitis and underwent a pouch procedure, which was subsequently resected. Twenty patients (67%) required parenteral nutrition. Three patients have undergone reversed intestinal segment to slow intestinal transit. Two patients underwent intestinal transplantation. Two patients have died: one from parenteral nutrition-related liver failure and the other after intestinal transplantation. Crohn's disease remains a common cause of SBS. Aggressive resectional therapy, surgical complications, and errors in initial diagnosis contribute to development of SBS in these patients. Selected patients are candidates for surgical therapy for SBS.

Original languageEnglish (US)
Pages (from-to)1069-1072
Number of pages4
JournalJournal of Gastrointestinal Surgery
Volume7
Issue number8
DOIs
StatePublished - Dec 1 2003

Fingerprint

Short Bowel Syndrome
Crohn Disease
Parenteral Nutrition
Transplantation
Ostomy
Colonic Diseases
Medical Errors
Intestinal Diseases

Keywords

  • Crohn's disease
  • Short bowel syndrome

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Short bowel syndrome and crohn's disease. / Thompson, Jon S; Iyer, Kishore R.; Dibaise, John K.; Young, Renee L.; Brown, Cindy R.; Langnas, Alan Norman.

In: Journal of Gastrointestinal Surgery, Vol. 7, No. 8, 01.12.2003, p. 1069-1072.

Research output: Contribution to journalArticle

Thompson, Jon S ; Iyer, Kishore R. ; Dibaise, John K. ; Young, Renee L. ; Brown, Cindy R. ; Langnas, Alan Norman. / Short bowel syndrome and crohn's disease. In: Journal of Gastrointestinal Surgery. 2003 ; Vol. 7, No. 8. pp. 1069-1072.
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