Short bowel syndrome in septic patients: a case report

Abstract

Short bowel syndrome is a global malabsorption state resulting from an inadequate length of intestine following intestinal resection. Residual bowel length is generally considered to be the primary determinant of outcome in these patients. This complex condition requires a multidisciplinary approach to reduce morbidity and mortality. In this case report we describe a 60-year-old female patient who underwent multiple bowel resections that resulted in postduodenal small intestine length of 30 cm with an end jejunostomy being formed. Her intensive care unit stay was complicated with respiratory failure, bilateral pneumonia and sepsis. She was mechanically ventilated and treated with antimicrobial agents according to microbial isolates and antibiograms. Total parenteral nutrition was started immediately after the surgery and enteral nutrition was gradually introduced. A multidisciplinary team consisting of anesthesiologists, surgeons and gastroenterologists participated in her treatment. After four months of hospital treatment the patient was discharged home equipped with a permanent tunneled central venous catheter and continued home parenteral nutrition in combination with oral feeding.