Short intestine syndrome and use of peripheral parenteral nutrition: case report
DOI:
https://doi.org/10.37497/JMRReview.v1i1.11Keywords:
Short Bowel Syndrome, Parenteral Nutrition, PediatricsAbstract
Background: Short bowel syndrome (SBS) is an uncommon malabsorptive condition, most often caused by massive surgical resection of the small intestine, although it can also be congenital, especially in pediatric cases. SBS is associated with significant morbidity and mortality, reduced quality of life, and high healthcare costs.
Aim: To report a case of SBS in a newborn treated at the Pediatrics Service of Hospital Universitário São Francisco in Providência de Deus (HUSF), located in the city of Bragança Paulista, SP, Brazil.
Case Report: It was a newborn who was referred to the Neonatal Intensive Care Unit. Subsequently, the patient underwent an exploratory laparotomy with enterectomy, right partial colectomy, ileostomy, transverse colon burial using the Hartmann technique, appendectomy and cavity drainage. With severe malnutrition, the newborn received peripheral parenteral nutrition (PPN) until weight gain began (15g/day). After his nutritional status improved, he was discharged with outpatient follow-up.
Conclusion: Although it is associated with high morbidity and mortality, pediatric SBS can be circumvented with the help of surgical procedures and subsequent PN, as demonstrated in the case reported here, which had a favorable outcome.
References
BATRA, A. et al. Epidemiology, management and outcome of ultrashort bowel syndrome in infancy. Archives of Disease in Childhood. Fetal and Neonatal Edition, v. 102, n. 6, p. F551–F556, nov. 2017. DOI: https://doi.org/10.1136/archdischild-2016-311765
BAXTER, K. J. et al. Pediatric short bowel syndrome and subsequent development of inflammatory bowel disease: an illustrative case and literature review. Pediatric Surgery International, v. 33, n. 6, p. 731–736, jun. 2017. DOI: https://doi.org/10.1007/s00383-017-4080-9
BELZA, C.; WALES, P. W. Multidisciplinary Management in Pediatric Ultrashort Bowel Syndrome. Journal of Multidisciplinary Healthcare, v. 13, p. 9–17, 2020. DOI: https://doi.org/10.2147/JMDH.S236130
BIELAWSKA, B.; ALLARD, J. P. Parenteral Nutrition and Intestinal Failure. Nutrients, v. 9, n. 5, p. E466, 6 maio 2017. DOI: https://doi.org/10.3390/nu9050466
BRUZONI, M. et al. Comparison of short bowel syndrome acquired early in life and during adolescence. Transplantation, v. 86, n. 1, p. 63–66, 15 jul. 2008. DOI: https://doi.org/10.1097/TP.0b013e3181734995
CARLSSON, E.; BOSAEUS, I.; NORDGREN, S. Quality of life and concerns in patients with short bowel syndrome. Clinical Nutrition (Edinburgh, Scotland), v. 22, n. 5, p. 445–452, out. 2003. DOI: https://doi.org/10.1016/S0261-5614(03)00042-6
CHANDRA, R.; KESAVAN, A. Current treatment paradigms in pediatric short bowel syndrome. Clinical Journal of Gastroenterology, v. 11, n. 2, p. 103–112, abr. 2018. DOI: https://doi.org/10.1007/s12328-017-0811-7
CHANNABASAPPA, N. et al. Enteral Nutrition in Pediatric Short-Bowel Syndrome. Nutrition in Clinical Practice: Official Publication of the American Society for Parenteral and Enteral Nutrition, v. 35, n. 5, p. 848–854, out. 2020. DOI: https://doi.org/10.1002/ncp.10565
COLE, C. R.; KOCOSHIS, S. A. Nutrition management of infants with surgical short bowel syndrome and intestinal failure. Nutrition in Clinical Practice: Official Publication of the American Society for Parenteral and Enteral Nutrition, v. 28, n. 4, p. 421–428, ago. 2013. DOI: https://doi.org/10.1177/0884533613491787
DIBAISE, J. K. 15 Home Parenteral Nutrition: Complications, Survival, Costs and Quality of Life. Intestinal Failure: Diagnosis, Management and Transplantation, p. 130, 2009. DOI: https://doi.org/10.1002/9781405195805.ch15
DUGGAN, C. P.; JAKSIC, T. Pediatric Intestinal Failure. The New England Journal of Medicine, v. 377, n. 7, p. 666–675, 17 ago. 2017. DOI: https://doi.org/10.1056/NEJMra1602650
FALCO, E. C. et al. Case Report: Morphologic and Functional Characteristics of Intestinal Mucosa in a Child With Short Bowel Syndrome After Treatment With Teduglutide: Evidence in Favor of GLP-2 Analog Safety. Frontiers in Nutrition, v. 9, p. 866048, 2022. DOI: https://doi.org/10.3389/fnut.2022.866048
GOULET, O.; RUEMMELE, F. Causes and management of intestinal failure in children. Gastroenterology, v. 130, n. 2 Suppl 1, p. S16-28, fev. 2006. DOI: https://doi.org/10.1053/j.gastro.2005.12.002
HÖLLWARTH, M. E. Surgical strategies in short bowel syndrome. Pediatric Surgery International, v. 33, n. 4, p. 413–419, abr. 2017. DOI: https://doi.org/10.1007/s00383-016-4043-6
KHAN, F. A. et al. Predictors of Enteral Autonomy in Children with Intestinal Failure: A Multicenter Cohort Study. The Journal of Pediatrics, v. 167, n. 1, p. 29- 34.e1, jul. 2015.
KORPELA, K. et al. Intestinal Microbiota Signatures Associated With Histological Liver Steatosis in Pediatric-Onset Intestinal Failure. JPEN. Journal of parenteral and enteral nutrition, v. 41, n. 2, p. 238–248, fev. 2017. DOI: https://doi.org/10.1177/0148607115584388
LAPPAS, B. M. et al. Parenteral Nutrition: Indications, Access, and Complications. Gastroenterology Clinics of North America, v. 47, n. 1, p. 39–59, mar. 2018. DOI: https://doi.org/10.1016/j.gtc.2017.10.001
MASSIRONI, S. et al. Understanding short bowel syndrome: Current status and future perspectives. Digestive and Liver Disease: Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, v. 52, n. 3, p. 253–261, mar. 2020. DOI: https://doi.org/10.1016/j.dld.2019.11.013
MERRITT, R. J. et al. Intestinal Rehabilitation Programs in the Management of Pediatric Intestinal Failure and Short Bowel Syndrome. Journal of Pediatric Gastroenterology and Nutrition, v. 65, n. 5, p. 588–596, nov. 2017. DOI: https://doi.org/10.1097/MPG.0000000000001722
MUTO, M. et al. An overview of the current management of short-bowel syndrome in pediatric patients. Surgery Today, v. 52, n. 1, p. 12–21, jan. 2022. DOI: https://doi.org/10.1007/s00595-020-02207-z
PIRONI, L. et al. ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults. Clinical Nutrition (Edinburgh, Scotland), v. 34, n. 2, p. 171–180, abr. 2015. DOI: https://doi.org/10.1016/j.clnu.2014.08.017
PIRONI, L. Definitions of intestinal failure and the short bowel syndrome. Best Practice & Research. Clinical Gastroenterology, v. 30, n. 2, p. 173–185, abr. 2016. DOI: https://doi.org/10.1016/j.bpg.2016.02.011
ROSSI, L. et al. Pediatric short bowel syndrome: adaptation after massive small bowel resection. Journal of Pediatric Gastroenterology and Nutrition, v. 45, n. 2, p. 213–221, ago. 2007. DOI: https://doi.org/10.1097/MPG.0b013e31803c75e8
STRUIJS, M.-C. et al. Establishing norms for intestinal length in children. Journal of Pediatric Surgery, v. 44, n. 5, p. 933–938, maio 2009. DOI: https://doi.org/10.1016/j.jpedsurg.2009.01.031
WALES, P. W. et al. Neonatal short bowel syndrome: population-based estimates of incidence and mortality rates. Journal of Pediatric Surgery, v. 39, n. 5, p. 690–695, maio 2004. DOI: https://doi.org/10.1016/j.jpedsurg.2004.01.036
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