Short bowel syndrome and surgical techniques for the baby with short intestines

The term short bowel syndrome (SBS) is defined by most authors as a state of significant maldigestion and malabsorption requiring prolonged parenteral nutrition. SBS was defined in term neonates by Rickham1 in 1967, as an extensive resection of all but a maximum of 75 cm of the small gut. This corresponds to 30% of the total jejunoileal length in term newborns. SBS in a premature newborn corresponds, according to Touloukian, to 30% of the calculated intestinal length for the given gestational age (GA), too.2 A more recent publication measuring bowel length in vivo shows that it is about 100 cm at GA of 27–29 weeks, 157 cm at 39–40 weeks, and 239 cm between 1 and 6 months.3 The term intestinal failure (IF) is often used for a larger group_{of patients with a variety of diseases and the inability to sustain an adequate homeostasis and growth by normal enteral nutrition.4}