ABSTRACT
Remarkable developments in medical care have occurred over the past half century, and the improvements in the treatment of patients with intestinal failure characterize this extraordinary evolution in enhanced patient outcome. Up until the 1960s and early 1970s, patients who sustained a massive infarction of the small bowel often went unresected at the time of laparotomy, because no nutritional supportive therapy was available for their care in the postoperative period. These individuals would succumb within days to overwhelming sepsis from their necrotic bowel. Patients with severe inflammatory bowel disease or extensive intra-abdominal adhesions would often undergo multiple operations over time but would gradually lose weight, live the life of a debilitated individual (e.g., an “intestinal cripple”), and eventually die of complications associated with yet another operation or of the consequences of severe malnutrition. Over the past 30 years, all of this has changed.
