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- Slide 1: Intestinal Rehab | Fundamentals | Made possible by Cincinnati Children's | A newborn with short bowel syndrome has 40 cm of small bowel. The colon is intact. You can restore continuity to the colon by anastomosis, or exclude it from the circuit. | WHAT IS THE BEST NEXT STEP? | 1/7
- Slide 2: Intestinal Rehab | Fundamentals | Made possible by Cincinnati Children's | THE ANSWER | RESTORE IT | Keep as much colon in continuity as you can. At this remnant length, the colon is doing a substantial share of the absorbing. | 2/7
- Slide 3: Intestinal Rehab | Fundamentals | Made possible by Cincinnati Children's | THE COLON ABSORBS CALORIES, NOT JUST FLUID | Bacteria ferment the carbohydrate the small bowel didn't absorb, and the right colon absorbs the short-chain fatty acids that result. Without those bacteria, the calories would leave in the stool. | UNABSORBED CARBS → FERMENTATION → ABSORPTION | 3/7
- Slide 4: Intestinal Rehab | Fundamentals | Made possible by Cincinnati Children's | The colon then becomes vitally important, because it assumes an increasing role in terms of energy absorption. | Paul Wales, MD, MSc | Surgical Director, Intestinal Rehabilitation, Cincinnati Children's | 4/7
- Slide 5: Intestinal Rehab | Fundamentals | Made possible by Cincinnati Children's | THE AMOUNT OF BOWEL LEFT SETS THE COLON'S VALUE | With most of the small bowel intact, colon length has little effect. Once the remnant drops below half of expected length for age, the colon takes on a growing share of energy and fluid absorption. | 5/7
- Slide 6: Intestinal Rehab | Fundamentals | Made possible by Cincinnati Children's | THE TAKEAWAY | PROTECT THE COLON, ESPECIALLY WHEN THE SMALL BOWEL IS SHORT | If they have less than half of expected bowel length for age, the colon is doing a lot of the absorption. | Measure the remaining small bowel, and keep as much colon in continuity as you can. | 6/7
- Slide 7: Intestinal Rehab | Fundamentals | Made possible by Cincinnati Children's | FOLLOW FOR MORE FUNDAMENTAL PEDIATRIC SURGERY EDUCATION. | 7/7
CCHMC - Carousel - Intestinal Rehab, Short Bowel Syndrome (Short Gut)
Topic overview
Educational carousel from Cincinnati Children's Hospital Medical Center covering intestinal rehabilitation approaches for short bowel syndrome, a condition requiring specialized nutritional and medical management in pediatric patients.
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