Biomaterial Database

Intestinal adaptation after extensive resection of the small intestine and prolonged administration of parenteral nutrition. 1976

M Scheflan, and S J Galli, and J Perrotto, and J E Fischer

After a superior mesenteric thrombosis in a 77 year old man, all but 24 centimeters of the jejunum were resected and anastomosed to the remaining left colon. After being maintained on parenteral nutrition on a 24 hour basis for six weeks, the patient was placed on overnight parenteral nutrition in which he received 2 liters of parenteral nutrition solution containing about 2,200 calories. Over a period of nine months, hypertrophy, lengthening and dilatation took place so that the patient was almost able to support himself by mouth. We believe that this is the first patient in whom documented lengthening of the small intestine has been reported. The factors entering into the hypertrophy and dilatation are discussed. Many patients in this age group are denied therapy because of the consequences of massive enterectomy. With adaptation using prolonged parenteral nutrition, it should be possible for most patients to sustain themselves completely by mouth. Patients with massive necrosis of the small intestine should not be denied therapy even if only 1 foot of small intestine remains. This is likely to hypertrophy in length until parenteral nutrition is no longer necessary.

UI	MeSH Term	Description	Entries
D007421	Intestine, Small	The portion of the GASTROINTESTINAL TRACT between the PYLORUS of the STOMACH and the ILEOCECAL VALVE of the LARGE INTESTINE. It is divisible into three portions: the DUODENUM, the JEJUNUM, and the ILEUM.	Small Intestine,Intestines, Small,Small Intestines
D007583	Jejunum	The middle portion of the SMALL INTESTINE, between DUODENUM and ILEUM. It represents about 2/5 of the remaining portion of the small intestine below duodenum.	Jejunums
D008297	Male		Males
D008641	Mesenteric Vascular Occlusion	Obstruction of the flow in the SPLANCHNIC CIRCULATION by ATHEROSCLEROSIS; EMBOLISM; THROMBOSIS; STENOSIS; TRAUMA; and compression or intrinsic pressure from adjacent tumors. Rare causes are drugs, intestinal parasites, and vascular immunoinflammatory diseases such as PERIARTERITIS NODOSA and THROMBOANGIITIS OBLITERANS. (From Juergens et al., Peripheral Vascular Diseases, 5th ed, pp295-6)	Mesenteric Vascular Occlusions,Occlusion, Mesenteric Vascular,Occlusions, Mesenteric Vascular,Vascular Occlusion, Mesenteric,Vascular Occlusions, Mesenteric
D009336	Necrosis	The death of cells in an organ or tissue due to disease, injury or failure of the blood supply.
D010288	Parenteral Nutrition	The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously).	Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D010289	Parenteral Nutrition, Total	The delivery of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously, or by some other non-alimentary route. The basic components of TPN solutions are protein hydrolysates or free amino acid mixtures, monosaccharides, and electrolytes. Components are selected for their ability to reverse catabolism, promote anabolism, and build structural proteins.	Hyperalimentation, Parenteral,Intravenous Hyperalimentation,Nutrition, Total Parenteral,Parenteral Hyperalimentation,Total Parenteral Nutrition,Hyperalimentation, Intravenous
D011182	Postoperative Care	The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)	Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000222	Adaptation, Physiological	The non-genetic biological changes of an organism in response to challenges in its ENVIRONMENT.	Adaptation, Physiologic,Adaptations, Physiologic,Adaptations, Physiological,Adaptive Plasticity,Phenotypic Plasticity,Physiological Adaptation,Physiologic Adaptation,Physiologic Adaptations,Physiological Adaptations,Plasticity, Adaptive,Plasticity, Phenotypic