ABSTRACT

The development of parenteral nutrition (PN) by Wilmore and Dudrick in 19681 enabled infants and children with short-bowel syndrome (SBS) to survive more than a few days postoperatively. Unfortunately, deleterious effects of PN, most notably intestinal failure-associated liver disease (IFALD) and complications related to central venous catheters, make its long-term use undesirable. The goal of intestinal rehabilitation programs to transition patients with intestinal failure to complete enteral nutrition has been met with variable success. While patients with adequate bowel length may achieve enteral autonomy prior to the development of PN complications, patients with extreme SBS may never wean from PN, or may develop serious complications of PN during the process.