Rodriguez Diana N, Ruiz Nicole C, Qian Steve, Kamel Amir Y
Internal Medicine, University of Florida Health Shands Hospital, Gainesville, USA.
Gastroenterology and Hepatology, Emory University, Atlanta, USA.
Cureus. 2023 Apr 20;15(4):e37897. doi: 10.7759/cureus.37897. eCollection 2023 Apr.
The etiologies of short bowel syndrome (SBS) can be stratified into congenital or acquired etiologies, with the latter being more prevalent. Small intestinal surgical resection is the most common acquired etiology, employed in settings including mesenteric ischemia, intestinal injury, radiation enteritis, and inflammatory bowel disease (IBD) complicated by internal fistulas. We describe a case of a 55-year-old Caucasian male with a history of idiopathic superior mesenteric artery (SMA) ischemia post-SMA placement complicated by recurrent small bowel obstructions. He presented with SMA stent occlusion and infarction, leaving him with 75 cm of post-duodenal small bowel after emergent surgical resection. He was trialed on enteral nutrition and progressed to parenteral nutrition (PN) after failure to thrive. With intensive counseling, his compliance improved, and he was able to briefly maintain adequate nutrition status with supplemental total parenteral nutrition. After a period of being lost to follow-up, he succumbed to complications from untreated SBS. This case highlights the need for intensive nutritional support for patients with short bowel syndrome and awareness of clinical complications.
短肠综合征（SBS）的病因可分为先天性或后天性病因，其中后者更为常见。小肠手术切除是最常见的后天性病因，见于肠系膜缺血、肠道损伤、放射性肠炎以及并发内瘘的炎症性肠病（IBD）等情况。我们描述了一例55岁的白种男性病例，其有特发性肠系膜上动脉（SMA）缺血病史，在置入SMA支架后并发复发性小肠梗阻。他因SMA支架闭塞和梗死就诊，急诊手术切除后十二指肠后小肠仅余75 cm。他先接受肠内营养试验，在生长发育不良后进展为肠外营养（PN）。经过强化咨询，他的依从性有所改善，通过补充全肠外营养能够短暂维持充足的营养状态。在失访一段时间后，他死于未经治疗的短肠综合征并发症。该病例凸显了对短肠综合征患者进行强化营养支持以及认识临床并发症的必要性。
