Intestinal Failure in Children: The European View

被引:129
作者
D'Antiga, Lorenzo [1 ]
Goulet, Olivier [2 ]
机构
[1] Osped Riuniti Bergamo, I-24128 Bergamo, Italy
[2] Univ Paris 05, Dept Pediat Gastroenterol Hepatol Nutr, French Reference Ctr Rare Digest Dis, Pediat Intestinal Failure Rehabil Ctr,Hop Necker, Paris, France
关键词
congenital enteropathy; home parenteral nutrition; intestinal failure-associated liver disease; intestinal pseudoobstruction syndrome; intestinal transplantation; parenteral nutrition; short bowel syndrome; SHORT-BOWEL SYNDROME; SERIAL TRANSVERSE ENTEROPLASTY; BACTERIAL OVERGROWTH; PARENTERAL-NUTRITION; GROWTH; MANAGEMENT; RESECTION; OUTCOMES; MILK; ADAPTATION;
D O I
10.1097/MPG.0b013e318268a9e3
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Intestinal failure (IF) is a condition in which severe intestinal malabsorption mandates artificial nutrition through a parenteral route. Causes of severe protracted IF include short bowel syndrome, congenital diseases of enterocyte development, and severe motility disorders (total or subtotal aganglionosis or chronic intestinal pseudo-obstruction syndrome). IF can result in nutritional failure, defined as the long-term failure to nourish a child by natural or artificial means. Today, IF-associated liver disease is the most common cause of parenteral nutrition (PN) failure, but catheter-related sepsis and extensive vascular thrombosis may also jeopardize the health of those receiving PN. For a child with nutritional failure, intestinal transplantation, often in the form of a composite visceral graft, offers the only chance for long-term survival. The management of IF requires a multidisciplinary approach. There have been a number of recent advances in both medical and surgical treatments of IF. In particular, new intestinal lengthening techniques and the use of PN formulas rich in fish oil both have resulted in decreased rates of severe complications of IF and its treatments. In addition, better awareness of the risks and benefits of intestinal transplantation have resulted in better patient selection, and ultimately in improved patient survival, hence restricting the indication to transplantation only to patients with nutritional failure and no other chance to survive.
引用
收藏
页码:118 / 126
页数:9
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