ABSTRACT

The primary cause of intestinal failure (IF) in children is catastrophic loss of intestinal length due to congenital or acquired conditions. Depending on the length of bowel remaining, the patient may suffer from short bowel syndrome (SBS). SBS is generally de—ned as loss of intestinal length resulting in a malabsorptive state and inability to maintain adequate hydration and nutrition.1 Most of these conditions are surgical in nature and pediatric patients requiring emergency surgical intervention for abdominal problems tend to be young infants, frequently premature, with associated small size and delicate conditions. They are often unstable or even moribund. The decisions that are made at the time of the initial procedure will, in many cases, have long-term consequences. Once bowel has been resected it cannot be replaced short of intestinal transplantation. The medical and surgical management of SBS will be discussed at length in other chapters of this text. The goal of this chapter is to discuss general principles of management during abdominal surgery with the intent to preserve as much bowel as possible. In some cases, SBS can be avoided entirely and in others, the severity of their condition may be improved.