Abstract
İnce bağırsağın 200 cm'den daha az devamlılıkta kalması olarak tanımlanan Kısa Bağırsak Sendromu, çeşitli prezentasyonlara sahip, sık görülen ve sıklıkla tedavisi zor komplikasyonlarla seyreden bir hastalıktır. En sık karşılaşılan komplikasyonlar temel olarak beslenme, gastrointestinal ve nefrolojiktir. Diğer sebeplerin yanı sıra mikrobesin ve ilaç malabsorbsiyonuna bağlı antikoagülasyon ve kemik bozukluklarıyla da karşılaşılmaktadır. Klinik takipler ve gerekli hususlar hastalar arasında farklılık gösterir. Hekimlerin gerekli müdahaleleri tahmin etmelerine yardımcı olmak için fonksiyonel, patofizyolojik, etiyolojik, klinik ve anatomik sınıflandırmalar mevcuttur. Burada farklı sunum ve prognozlara sahip üç vakayla ilgili deneyimlerimizin bir özetini sunuyoruz. Yönetimi sırasında karşılaşılan sorunları mevcut literatür ve kılavuzlar ışığında tartışıyoruz. Bağırsak yetmezliği ve kısa bağırsak sendromu vakalarının tedavisinde özel birimler ve çok bölümlü yaklaşım hala hayati önem taşır ve daha iyi araçlara ve daha fazla araştırmaya ihtiyaç mevcuttur.
References
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- Roberts K, Shah ND, Parrish CR, Wall E. Navigating nutrition and hydration care in the adult patient with short bowel syndrome. Nutr Clin Pract. 2023;38 Suppl 1:S59-S75. doi:10.1002/ncp.10951
- Hong WBT, Tan WK, Law LSC, Ong DEH, Lo EAG. Changes of Drug Pharmacokinetics in Patients with Short Bowel Syndrome: A Systematic Review. Eur J Drug Metab Pharmacokinet. 2021;46(4):465-478. doi:10.1007/s13318-021-00696-y
- Schiellerup SP, Skov-Jeppesen K, Windeløv JA, et al. Gut Hormones and Their Effect on Bone Metabolism. Potential Drug Therapies in Future Osteoporosis Treatment. 2019;10:75. doi:10.3389/fendo.2019.00075
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- Gompelman M, Causevic E, Bleeker-Rovers CP, Wanten GJA. Catheter-related bloodstream infection management in patients receiving home parenteral nutrition: An observational cohort study. Clin Nutr ESPEN. 2022;50:155-161. doi:10.1016/j.clnesp.2022.06.003
Abstract
Short Bowel Syndrome, defined as remaining small bowel in continuity of less than 200 cm, is a disorder with varied presentations and frequent and often difficult-to-manage complications. The most commonly encountered complications are mainly nutritional, gastrointestinal and nephrological. Anticoagulation and bone disorders due to micronutrient and drug malabsorption, among other causes, are also encountered. The clinical follow-ups and considerations necessary vary between patients. Functional, pathophysiological, etiological, clinical and anatomical classifications exist to help physicians predict the required interventions. Herein, we summarise our experience with three cases with differing presentations and prognoses. We discuss the problems encountered during their management in light of the existing literature and guidelines. Specialised units and a multi-departmental approach remain vital in managing intestinal failure and short bowel syndrome; better tools and further research are yet to be required.
References
- Pironi L, Arends J, Bozzetti F, et al. ESPEN guidelines on chronic intestinal failure in adults. Clin Nutr. 2016;35(2):247-307. doi:10.1016/j.clnu.2016.01.020
- Bratton H, Alomari M, Al Momani L, et al. Etiology of and predictive factors for chronic intestinal failure requiring long term parenteral support in the last two decades: A retrospective study. Clin Nutr ESPEN. 2020;37:168-172. doi:10.1016/j.clnesp.2020.02.019
- Pironi L, Cuerda C, Jeppesen PB, et al. ESPEN guideline on chronic intestinal failure in adults - Update 2023. Clin Nutr. 2023;42(10):1940-2021. doi:10.1016/j.clnu.2023.07.019
- Phelps HM, Warner BW. Intestinal adaptation and rehabilitation. Semin Pediatr Surg. 2023;32(3):151314. doi:10.1016/j.sempedsurg.2023.151314
- Pironi L, Boeykens K, Bozzetti F, et al. ESPEN practical guideline: Home parenteral nutrition. Clin Nutr. 2023;42(3):411-430. doi:10.1016/j.clnu.2022.12.003
- Roberts K, Shah ND, Parrish CR, Wall E. Navigating nutrition and hydration care in the adult patient with short bowel syndrome. Nutr Clin Pract. 2023;38 Suppl 1:S59-S75. doi:10.1002/ncp.10951
- Hong WBT, Tan WK, Law LSC, Ong DEH, Lo EAG. Changes of Drug Pharmacokinetics in Patients with Short Bowel Syndrome: A Systematic Review. Eur J Drug Metab Pharmacokinet. 2021;46(4):465-478. doi:10.1007/s13318-021-00696-y
- Schiellerup SP, Skov-Jeppesen K, Windeløv JA, et al. Gut Hormones and Their Effect on Bone Metabolism. Potential Drug Therapies in Future Osteoporosis Treatment. 2019;10:75. doi:10.3389/fendo.2019.00075
- Madnawat H, Welu AL, Gilbert EJ, et al. Mechanisms of parenteral nutrition-associated liver and gut injury. Nutr Clin Pract. 2020;35(1):63-71. doi:10.1002/ncp.10461
- Gompelman M, Causevic E, Bleeker-Rovers CP, Wanten GJA. Catheter-related bloodstream infection management in patients receiving home parenteral nutrition: An observational cohort study. Clin Nutr ESPEN. 2022;50:155-161. doi:10.1016/j.clnesp.2022.06.003
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Case report |
| Authors | |
| Early Pub Date | September 11, 2024 |
| Publication Date | September 16, 2024 |
| Submission Date | April 16, 2024 |
| Acceptance Date | June 12, 2024 |
| Published in Issue | Year 2024 Volume: 9 Issue: 3 |
