ABSTRACT
S hort bowel syndrome (SBS) is the m ost serious long-term gastrointestinal com plication associated with surgically treated N EC . SBS occurs in up to 23% of survivors who undergo surgical management for N E C .1 Patients who develop SBS require parenteral nutrition for survival. The long-term use o f parenteral nutrition in this patient population is associated with the development o f cholestasis which can lead to cirrhosis, sepsis, and increased mortality. In patients with sustained direct bilirubin levels o f more than 4 mg/dl for more than 6 months, an 80% mortality rate is expected.2 Addi tionally the financial burden o f prolonged parenteral nutrition use is heavy. The average cost o f maintaining a pediatric patient on home parenteral nutrition ranges from $100,000 to $150,000 per year.2 Fortunately most patients with SBS eventually undergo sufficient intestinal adaptation to be weaned off parenteral nutrition. Long-term survival in children with SBS is expected to be at least 85% .3 In those patients with SBS secondary to N E C that are refractory to medical or surgical management, bowel transplantation remains an option.
