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Pediatric short bowel syndrome and subsequent development of inflammatory bowel disease: an illustrative case and literature review

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Abstract

Short bowel syndrome (SBS) in neonates is an uncommon but highly morbid condition. As SBS survival increases, physiologic complications become more apparent. Few reports in the literature elucidate outcomes for adults with a pediatric history of SBS. We present a case report of a patient, born with complicated gastroschisis resulting in SBS at birth, who subsequently developed symptoms and pathologic changes of inflammatory bowel disease (IBD) as an adult. The patient lived from age 7, after a Bianchi intestinal lengthening procedure, to age 34 independent of parenteral nutrition (PN), but requiring hydration fluid via G-tube. He was then diagnosed with IBD, after presenting with weight loss, diarrhea, and malabsorption, which required resumption of PN and infliximab treatment. This report adds to a small body of the literature which points to a connection between SBS in neonates and subsequent diagnosis of IBD. Recent evidence suggests that SBS and IBD have shared features of mucosal immune dysfunction and altered intestinal microbiota. We review current treatment options for pediatric SBS as well as multidisciplinary and coordinated transition strategies. We conclude that there may be an etiologic connection between SBS and IBD and that this knowledge may impact outcomes and approaches to care.

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Authors and Affiliations

  1. Division of Pediatric Surgery, Department of Surgery, Children’s Healthcare of Atlanta, Emory University School of Medicine, 1405 Clifton Road NE, Atlanta, GA, 30322, USA

    Katherine J. Baxter, Richard R. Ricketts & Megan M. Durham

  2. Division of General and GI Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA

    Jahnavi K. Srinivasan

  3. Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA

    Thomas R. Ziegler

  4. Division of Gastroenterology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA

    Tanvi Dhere

Authors
  1. Katherine J. Baxter
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  2. Jahnavi K. Srinivasan
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  3. Thomas R. Ziegler
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  4. Tanvi Dhere
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  5. Richard R. Ricketts
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  6. Megan M. Durham
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Correspondence to Katherine J. Baxter.

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Baxter, K.J., Srinivasan, J.K., Ziegler, T.R. et al. Pediatric short bowel syndrome and subsequent development of inflammatory bowel disease: an illustrative case and literature review. Pediatr Surg Int 33, 731–736 (2017). https://doi.org/10.1007/s00383-017-4080-9

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  • DOI: https://doi.org/10.1007/s00383-017-4080-9

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