短腸症候群に対して栄養管理が効を奏した１例

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  • Nutrient Management in a Patient with Severe Short Bowel Syndrome

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A 67-year-old man was admitted to our hospital because of acute abdominal pain. We performed an emergency laparotomy under a diagnosis of acute abdomen. Extensive bowel necrosis caused by a mesenteric circulatory disturbance was found, and a broad resection including the small intestine and the right and transverse colon was performed. A primary anastomosis was performed because the remnant small intestine was too short to perform an ileostomy. Despite the presence of peritonitis, we were able to save the patient's life ; no severe complications, like ruptured sutures, occurred. The patient's residual small intestine was only about 10 cm in length, causing significant digestive malabsorption. The patient is presently receiving short-chain fatty acids and glutamine, administered as intestinal trophic factors, in an effort to improve intestinal digestive absorption. Patients with short bowels and digestive malabsorption may require additional therapeutic agents to wean them from TPN.

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