Short bowel syndrome

First one with correct answer with justification win. [size=20px]Given an equivalent length of remaining intestine, which of the following etiologies of intestinal failure / short bowel syndrome in infancy has a higher likelihood to attain enteral autonomy? A jejunal atresia B gastroschisis C necrotizing enterocolitis D volvulus E cystic fibrosis[/size]

Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "Surgery is indicated only for selected patients with any one of three conditions: (1) when the absorptive surface area is definitely too small to allow enteral feeding; (2) when severe dysmotility in grossly dilated loops entails stagnation of chyme; and (3) when intestinal transit time is too fast to allow sufficient absorption of nutrients. In the first group of patients, intestinal transplantation is the mainstay of surgical therapy. In the second group, peristalsis can be improved by intestinal tapering or tapering and lengthening. In the third group, antiperistaltic segme…

Quotes from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "Resection of the jejunum is well tolerated owing to the enormous adaptive capacity of the ileum, the intact enterohepatic circulation of bile salts, and the preserved absorption of fat-soluble vitamins and vitamin B12. In contrast, if the entire ileum is lacking, absorption of nutrients is significantly more difficult because of the limited intestinal adaptation capacities of the jejunum. Nonabsorbed intestinal contents, including bile acids, spill over into the colon and may cause significant diarrhea. Furthermore, loss of the ileum leads to a reduction of the bile salt pool…

Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "The term “short bowel” was defined by Rickham in 1967 as a small intestinal remnant of 75 cm or less in the newborn, which equals 30% of normal small bowel length in that age group. A more functional description, preferred by most authors, defines a “short bowel syndrome” (SBS) as a state of significant maldigestion and malabsorption due to an extensive loss of functional absorptive intestinal surface area."

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Any one want a high quality PDF of this chart, post in this thread and use a personalized picture as an avatar, I will send it to you in a private message Edit: available without restrictions

A 12-month old baby had midgut volvulus as a newborn which resulted in 25 cm of small intestine with an intact ileocecal valve. He requires long term total parenteral nutrition. Over the past six months, he has not been able to go beyond 10 mL/hr of continuous gastric feedings because of high volume diarrhea. His small bowel follow through and subsequent delayed films show contrast into the colon [center][/center] [size=20px]The most reasonable next approach to increase his ability to tolerate enteral feedings is A serial transverse enteroplasty. B intestinal transplantation. C jejunal feeds. D use of teleglutide. E intravenous antibiotics.[/size]