[Short bowel syndrome in children - own experience]. / Zespól krótkiego jelita u dzieci-obserwacje wlasne.

ABSTRACT

THE AIM: of this study was to analyze the clinical status of children with short bowel syndrome (SBS) shortly after the resection and during following years. MATERIAL AND METHODS: we reviewed retrospectively 5 children with SBS aged from 2 years and 7 months till 14 years and 5 months, who were on total parenteral nutrition due to intestinal resection. The resection was performed, when they were either newborns or infants. In the analysis we considered somatic development and laboratory tests results. In 4 cases the cause for extensive bowel resection were congenital anomalies of the intestine, in one case it was intestinal necrosis as result of invagination. RESULTS: in all children there was diarrhea, during postoperative period and when oral caloric intake was increased and when loss of weight was observed. Most common complications included hypochromic anaemia and cholestasis. Moreover, in 2 children with resection of distal region of the ileum and ascending colon, we observed vitamin B12 deficiency and recurrent lactic acidosis due to secondary biotin deficiency. Catheter complications were one of the main problems. 3 patients developed sepsis. Occlusion or mechanic damage of the catheter were also observed. Despite initial severe retardation in somatic development, final anthropometric evaluation in all children was found to be normal. CONCLUSIONS: 1. Congenital intestinal and mesenteric defects were the most common reasons for SBS in the youngest children. 2. Parenteral nutrition is the cardinal element in the management. It was crucial for survival and further normal somatic development, even in children after extensive intestinal resection. 3. Lactic acidosis due to biotin deficiency must be considered if acid-base balance restoration is complicated in children with SBS. 4 Children with SBS after resection need long-term and multi specialistic medical care.