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Your search term(s) "short bowel syndrome" returned 19 results.

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Short Bowel Syndrome. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2009. 10 p.

This fact sheet describes short bowel syndrome, defined as a group of problems related to poor absorption of nutrients that typically occurs in people who have had half or more of their small intestine removed. People with short bowel syndrome cannot absorb enough water, vitamins, and other nutrients from food to sustain life. The fact sheet answers common questions about short bowel syndrome, including its causes, signs and symptoms, treatment strategies, and intestinal adaptation. Diarrhea is the main symptom of short bowel syndrome and can lead to dehydration, malnutrition, and weight loss. Treatment may involve use of oral rehydration solutions, parenteral nutrition, enteral nutrition, and medications. Intestinal transplantation may be an option for some patients. The fact sheet includes a brief description of current research in this area. Readers are referred to two resource organizations: the Crohn’s and Colitis Foundation of America at 1–800–932–2423 or www.ccfa.org and the Oley Foundation at 1–800–776–OLEY or www.oley.org for more information. The document concludes with a summary of the activities of the National Digestive Diseases Information Clearinghouse (NDDIC), a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 1 figure.

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Dietary Challenge: Maximizing Bowel Adaptation in Short Bowel Syndrome. Today's Dietitian. 9(1): 40-44. January 2007.

This article discusses medical nutrition therapy (MNT), including parenteral therapy, to help patients with short bowel syndrome (SBS) maximize their bowel adaptation after surgery. The author notes that initiating parenteral nutrition (PN) therapy is easy, but it requires a skilled dietitian to wean a patient off PN and back to oral nutrition. The registered dietitian (RD) is instrumental in recommending early oral diet advancement and guiding the patient toward appropriate choices that will help maximize bowel adaptation and minimize complications. Topics include SBS and its impact on nutrition, medications, etiologies of SBS, establishing the PN prescription, dietary modification, macronutrients, oral rehydration solutions, vitamins and minerals, glutamine, growth hormone, glucagon-like peptide-2 (GLP2), and intestinal rehabilitation programs. One sidebar lists resources for addition information on oxalate content of foods, on oral rehydration solutions, and on SBS. References are available online. 2 tables.

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Growth Factors in Short-Bowel Syndrome Patients. Gastroenterology Clinics of North America. 36(1): 109-122. 2007.

This article, from a special issue of Gastroenterology Clinics of North America that covers nutrition in gastrointestinal illness, discusses growth factors in patients with short-bowel syndrome. The author notes that malabsorption of nonessential and essential nutrients, fluids, and electrolytes, if not compensated for by increased intake, is a key finding in patients with short-bowel syndrome. Dependence on parenteral nutritional (PN) support significantly impairs the quality of life in these patients and is associated with complications, including recurrent infections, increased risk of venous thrombosis, and PN-associated liver failure. The author focuses on selected factors responsible for the morphologic and functional changes in the adaptive processes and presents results of clinical trials that use either growth hormone or glucagon-like peptide (GLP)-2 to facilitate a condition of hyperadaptation in short-bowel patients. Intestinal adaptation refers to the progressive recovery from intestinal insufficiency or failure that follows a loss of intestinal length. The author concludes that the effects of high doses of growth hormone are related to the wet-weight absorption (or fluid retention) and mainly in patients with a preserved colon, whereas the effects on energy absorption are minimal. 1 figure. 1 table. 54 references.

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Nutrition in Gastrointestinal Illness. Gastroenterology Clinics of North America. 36(1):1-218. March 2007.

This issue of Gastroenterology Clinics of North America focuses on nutrition in gastrointestinal illness. The issue includes 11 articles: nutritional assessment; the complications of parenteral nutrition; prebiotics, probiotics, and dietary fiber in gastrointestinal disease; nutrition support in acute pancreatitis; food allergies and eosinophilic gastrointestinal illness; nutritional deficiencies in celiac disease; growth factors in people with short-bowel syndrome; home parenteral and enteral nutrition; intestinal transplantation; metabolic bone disease in gastrointestinal illness; and obesity management. The editor of the issue stresses that it is vital for gastroenterologists to understand the role of the gastrointestinal tract in nutrient assimilation and to understand when and how to intervene when nutrient assimilation is compromised in order to prevent the development of systemic nutrient disorders. Each article concludes with a list of references for additional information. A detailed subject index is included with the issue.

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Restoring GI Autonomy to Intestinal Failure Patients. Lifeline. 27(3): 1-2, 6-7. May-June 2007.

This article from a newsletter for people living with home parenteral or enteral nutrition (HPEN) reviews the steps to returning gastrointestinal autonomy to people with intestinal failure, usually those with short bowel syndrome. The author briefly reviews the usual care for these patients, which consists of initiating parenteral nutrition (PN) and then waiting for transplant, and proposes a different strategy that encompasses a more formal approach to intestinal rehabilitation. The author’s approach includes nutrition, medical, and surgical procedures in an attempt to wean a patient off PN if possible. When weaning is not possible, the goal shifts to prevention of PN complications. The author describes this approach in detail, including surgical techniques that might be used in different situations. A final section discusses the controversy over making intestinal failure patients wait until advanced liver disease mandates a combined liver-intestinal transplant. A patient care algorithm is provided.

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Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. 674 p.

This comprehensive textbook compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders of the stomach, intestines, liver, pancreas, and colon, as well as other diseases that affect the gastrointestinal (GI) tract. The 53 chapters are organized into seven sections: nutritional assessment, general nutrition, nutrition in GI disease, nutrition in the critical care environment, management of intestinal failure, nutritional support, and obesity. Specific topics include body composition analysis, micronutrient deficiencies, the clinical consequences of undernutrition, the malabsorption syndrome, general nutrition, Dietary Reference Intakes (DRIs), the dietary treatment of GI diseases, macronutrient digestion and metabolism, food allergies, dietary supplements, prebiotics and probiotics, dietary fiber, food and water safety, metabolic bone disease in GI illness, nutrition in the elderly, nutrition and alcoholism, nutrition and diabetes mellitus, nutrition and colorectal cancer, nutritional support in inflammatory bowel disease, celiac disease, nutrition and liver disease, nutrition in chronic pancreatitis, nutritional support in acute pancreatitis, nutrition and GI motility in health and disease, inborn errors of metabolism for the gastroenterologist, nutrition and cystic fibrosis, nutrition and GI oncology, the metabolic response to critical illness, the clinical implications of oxidative stress and antioxidant therapy in GI disease, perioperative nutritional support, dietary management in short bowel syndrome, nontransplant surgery for short bowel syndrome, intestinal transplantation, the use of growth factors in short bowel syndrome, indications and contraindications to enteral and parenteral nutrition (PN), vascular access for the patient receiving PN, PN formulas, pediatric PN, complications of long-term PN, complications of enteral nutrition (EN), home PN in infants, children, and adults, administration routes for EN, formulas and supplements for adult EN, pediatric enteral formulas, home EN, refeeding syndrome, the medical, legal, and ethical aspects of nutritional support, the medical management of obesity, control of food intake, the surgical management of obesity, the GI complications of bariatric surgery, the genetic and nutritional aspects of hyperlipidemia, the management of childhood obesity, and the nutritional support of obese and bariatric patients. Each chapter includes black-and-white figures and tables and concludes with a list of references. A detailed subject index concludes the volume.

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Dietary and Medical Management of Short Bowel Syndrome in Adult Patients. Journal of Clinical Gastroenterology. 40 (Suppl 2): S85-S93. May-June 2006.

This article reviews the dietary and medical management of short bowel syndrome (SBS) in adult patients, a condition that can result from resection of the small bowel. SBS is accompanied by malabsorption of fluid, electrolytes, minerals, and other essential nutrients, resulting in malnutrition and dehydration. Medical nutrition therapy (MNT) in these patients can help optimize intestinal absorption, helping patients lead as normal a lifestyle as possible. Parenteral nutrition (PN), often used to supply the required nutrients following resection, is associated with a number of complications affecting patient morbidity and mortality. Thus, patients should be weaned off PN as quickly as possible. In addition to nutrient intake, management of SBS also requires appropriate oral rehydration, vitamin and mineral supplementation, and drug therapy. The authors discuss several medications that may prove useful for these patients, including antidiarrheal agents, H2 antagonists and proton pump inhibitors (PPIs), pancreatic enzymes, somatostatin analogs, antimicrobials, and trophic factors. The authors conclude that dietary management of this patient population is complex and must be individualized for each patient in the context of his or her daily life. 8 tables. 79 references.

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Dietary Management in Short Bowel Syndrome. IN: Buchman, A., ed. Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 357-366.

This chapter about short bowel syndrome (SBS) is from a comprehensive textbook that compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders that affect the gastrointestinal (GI) tract. The authors define SBS as a collection of signs and symptoms occurring after massive surgical intestinal resection. SBS is characterized by weight loss and malabsorption of fluids and macro- and micronutrients. SBS can be congenital or can result from surgical bowel resection that was performed for recurrent Crohn’s disease, an acute event, or necrotizing enterocolitis. Topics covered include intestinal adaptation following resection, the medical therapy of SBS, dietary management, carbohydrates, dietary fats, dietary fiber, proteins and amino acids, dietary restrictions, fluid and electrolyte management, vitamins, and trace metals. Patients with less than 150 to 200 centimeters of remaining small intestine without a colon may have significant energy and fluid losses and may require parenteral nutrition (PN) for survival. In contrast, patients with a partial or complete remaining colon in continuity with the small intestine may not have significant fluid and energy loss until less than 50 to 70 centimeters of the small bowel remains. 104 references.

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Nontransplant Surgery for Short Bowel Syndrome. IN: Buchman, A., ed. Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 367-374.

This chapter about nontransplant surgery for short bowel syndrome (SBS) is from a comprehensive textbook that compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders that affect the gastrointestinal (GI) tract. The author defines SBS as a specific form of intestinal failure resulting from inadequate length of functional small bowel. The syndrome is characterized by a failure to meet the body’s need for calories and macro- and micronutrients via the enteral route. Many of the complications related to the syndrome, such as liver disease and frequent life-threatening septic episodes, are related to the provision of total parenteral nutrition (TPN) and the obligatory need for long-term central venous access. The chapter covers the role of the surgeon in management of SBS, the principles of early surgical management, surgery to correct slow transit and improve intestinal motility, and surgery to increase mucosal surface area. The author concludes that improvements in the understanding of the physiology of intestinal failure and adaptation have contributed to the improvement in surgical outcomes for SBS. Intestinal transplantation is discussed briefly. 1 table. 52 references.

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Dietary Treatment of Gastrointestinal Diseases. IN: Buchman, A., ed. Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 63-76.

This chapter about the dietary treatment of gastrointestinal (GI) diseases is from a comprehensive textbook that compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders that affect the GI tract. The author defines medical nutrition therapy (MNT) as diet modification, nutrient supplementation, nutrition support, and nutrition counseling as modes of therapy for disease. The chapter focuses on dietary modifications that are used to treat hospitalized or ambulatory patients with diseases of the mouth, esophagus, stomach, intestine, liver, and pancreas. The chapter covers modifications in consistency, including the clear liquid diet, the soft low-residue diet, mechanically altered diets, and the liquid diet following oral surgery; a diet for gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD); a diet following gastrectomy, including dietary modifications for dumping syndrome, and those for gastric bypass or gastric stapling for obesity; a diet for lactose intolerance or hypolactasia; a gluten-restricted diet for celiac disease; MNT for inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, and the role of foods or dietary patterns in the etiology of IBD; a diet for ileostomy and colostomy; a diet for short bowel syndrome; a diet for acute and chronic pancreatitis; a diet to control diarrhea; a diet for constipation and diverticulosis; and sodium and protein restricted diets for liver disease, including concerns about ascites and sodium intake, and the use of protein restriction and branched chain amino acid formulas in patients with chronic liver disease and hepatic encephalopathy. The author concludes by cautioning that these diets should be used with moderation, particularly when they do not provide all nutrients. They may exacerbate existing nutrition problems and malabsorption, altered metabolism, and increased secretory losses of nutrients. 4 tables. 95 references.

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Home Parenteral Nutrition in Infants, Children, and Adults. IN: Buchman, A., ed. Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 485-492.

This chapter about home parenteral nutrition (PN) is from a comprehensive textbook that compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders that affect the gastrointestinal (GI) tract. The authors describe the use of home PN in infants, children, and adults, noting that the delivery of PN in the home can allow patients the ability to thrive and maintain an active lifestyle without the need for hospitalization. This chapter covers the history of home PN; indications for home PN, including short bowel syndrome, motility disorders, severe mucosal injury, congenital malabsorptive syndromes, trauma and vascular accidents, intractable chylous ascites/chylothorax, and inflammatory bowel disease (IBD); contraindications; formulations; delivery; catheters; catheter and site care, including dressing changes; fluid requirements in home PN; nutrient requirements in home PN, including electrolytes, chloride, potassium, bicarbonate, carbohydrates, lipids, parenteral proteins, calcium, magnesium, and phosphorus; complications; costs; outpatient care; team-centered care; and discontinuing home PN. The authors note that progress continues to be made in decreasing the incidence of catheter-related sepsis, although PN-related cholestasis remains a significant problem. 1 table. 39 references.

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Indications and Recommendations for the Use of Recombinant Human Growth Hormone in Adult Short Bowel Syndrome Patients Dependent on Parenteral Nutrition. Journal of Clinical Gastroenterology. 40 (Suppl 2): S99-S106. May-June 2006.

This article reviews indications and recommendations for the use of recombinant human growth hormone (r-hGH) in adult patients with short bowel syndrome (SBS), a condition that can result from resection of the small bowel. SBS is accompanied by malabsorption of fluid, electrolytes, minerals, and other essential nutrients, resulting in malnutrition and dehydration. This article presents information gleaned from a meeting of a group of experts in this field, convened to discuss best-practice strategies in the face of no published guidelines regarding the use of trophic factors to treat patients with SBS who are also on parenteral nutrition (PN). Trophic factors, such as r-hGH and glucagon-like peptide-2 (GLP2) may enhance intestinal adaptation and decrease PN requirements. Available clinical data on the use of r-hGH therapy in SBS patients were discussed, as were the utility of r-hGH in the PN weaning process, the optimal timing of r-hGH therapy, and how to select appropriate patients for r-hGH therapy. The meeting culminated with the development of a treatment algorithm to summarize best-practice recommendations for the management of SBS in adult patients. This algorithm involves beginning the weaning process off PN without the use of trophic factors; for patients in whom this is not successful, r-hGH regimens may be utilized. 1 figure. 1 table. 67 references.

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Malabsorption Syndrome. EndoNurse. 6(2): 40-41. April-May 2006.

This article familiarizes nurses with malabsorption syndrome, defined as an alteration in the ability of the intestine to absorb nutrients adequately into the bloodstream. Many different conditions affect fluid and nutrient absorption by the intestine, including cystic fibrosis, chronic pancreatitis, celiac disease (gluten intolerance), short bowel syndrome, Whipple’s disease, inflammatory bowel disease, and irritable bowel syndrome. The author outlines the symptoms of malabsorption syndrome, which can include anemia, diarrhea, steatorrhea (excessive fat in the stool), abdominal cramping, bloating, edema, malnutrition and weight loss, muscle cramping, perianal skin burning or itching, and the development of secondary nutritional deficiencies. The author stresses that fluid and nutrient monitoring and replacement are essential for any individual with malabsorption syndrome. Consultation with a dietitian to assist with nutritional support and meal planning is helpful. Medical management for malabsorption is dependent upon the cause, for example, treatment for celiac disease means the use of a lifelong gluten-free diet. References for the article are available at www.endonurse.com.

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Nutrition and Gastrointestinal Motility in Health and Disease. IN: Buchman, A., ed. Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 271-280.

This chapter about nutrition and gastrointestinal (GI) motility in health and disease is from a comprehensive textbook that compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders that affect the GI tract. The authors focus on the physiology of the control of the transit of a meal through the gut and the information needed for nutritional management when such controls are impaired. Each section reviews the normal controls that govern meal transit and provides an example of disordered motility to discuss nutritional management strategies. The sections include the mouth and esophagus, the stomach, the small intestine, and the colon. Specific disorders and conditions discussed are the dysphagias, oropharyngeal dysphagia secondary to stroke, esophageal dysphagia secondary to scleroderma, gastroesophageal reflux disease (GERD), gastric sieving, peristalsis, chemical hydrolysis, gastric emptying, nutrient- and load-dependence of gastric emptying, delayed gastric emptying, accelerated emptying and fat intolerance, delayed small intestine transit and postoperative ileus, delayed transit and scleroderma, the ileal and jejunal brakes, the importance of nutrient-regulated intestinal motility, small intestinal bacterial overgrowth, accelerated transit and short bowel syndrome, and the colonic brake. The author concludes that for all patients with a motility disorder, it is critical to determine not only the location of the dysfunction but also whether symptoms are caused by motility that is too fast or too slow. The most effective treatment strategy is the accurate identification of a reversible mechanism from which the symptoms arise. 98 references.

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Role of Growth Factors and Glutamine in Enhancing Gut Adaptation. Lifeline Letter. 27(3): 1-2, 10. May-June 2006.

This patient education article, from a newsletter for people on home parenteral or enteral nutrition (HPEN), reviews the role of growth factors and glutamine in enhancing gut adaptation. The author reports on research on several growth factors and amino acids undertaken to see whether they can enhance bowel adaptability and therefore reduce parenteral nutrition (PN) dependency in patients with short bowel syndrome (SBS). The author discusses the factors that influence bowel adaptation and lower PN dependence. In patients with SBS, adaptation is the process during which the intestine ‘grows,’ that is, increases in diameter, after which total surface area increases and absorption improves. This process occurs naturally, is thought to be most active in the first six months following resection, and is generally considered to be completed by one or two years after surgery. The author focuses on problems of fluid losses and reduced nutrient absorption, the role of the colon, and artificial enhancements to the natural adaptation process, notably growth hormone and glutamine. 1 figure.

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Strategies for Parenteral Nutrition Weaning in Adult Patients with Short Bowel Syndrome. Journal of Clinical Gastroenterology. 40 (Suppl 2): S94-S98. May-June 2006.

This article reviews strategies for parenteral nutrition (PN) weaning in adult patients with short bowel syndrome (SBS), a condition that can result from resection of the small bowel. SBS is accompanied by malabsorption of fluid, electrolytes, minerals, and other essential nutrients, resulting in malnutrition and dehydration. Medical nutrition therapy (MNT) in these patients can help optimize intestinal absorption, helping patients lead as normal a lifestyle as possible. Parenteral nutrition (PN), often used to supply the required nutrients following resection, is associated with a number of complications affecting patient morbidity and mortality. The authors describe strategies of PN weaning and illustrate important clinical considerations during the weaning process. Daily fluid and caloric intake goals must be met prior to initiating PN weaning. During weaning, the most practical measures for assessing adequate hydration and nutritional status are oral intake, stool and urine output, serum electrolytes and visceral proteins, and body weight. PN reductions can be made by either decreasing the days of PN infusion per week or by decreasing the PN infusion volume equally across all days of the week. Patient education and motivation are key factors in successful PN weaning. Other factors likely to influence weaning success include the length and health of the remnant bowel, the presence of a colon, and the degree to which bowel adaptation has occurred. 1 figure. 2 tables. 45 references.

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Treatment of Adult Short Bowel Syndrome with Recombinant Human Growth Hormone: A Review of Clinical Studies. Journal of Clinical Gastroenterology. 40 (Suppl 2): S75-S84. May-June 2006.

Extensive resection of the intestinal tract frequently results in inadequate digestion or inadequate absorption of nutrients, a condition known as short bowel syndrome (SBS). This article reviews the clinical studies that investigated the treatment of adult SBS with recombinant human growth hormone (r-hGH). In one randomized, controlled study and five open-label studies, treatment with r-hGH significantly increased absorption of energy, protein, and carbohydrates. Four studies also demonstrated significantly increased body weight, lean body mass, total body potassium, or total body water in response to r-hGH. However, in two other randomized controlled trials, r-hGH had no significant effect on energy or fluid absorption. In one randomized, controlled study and six open-label trials, treatment with r-hGH also allowed a majority of patients, including those with no colon and significant bowel resection, to eliminate or substantially reduce parenteral nutrition (PN). The best clinical results appear to be achieved when r-hGH is administered in combination with a specialized oral diet and perhaps with glutamine. 5 figures. 2 tables. 40 references.

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Use of Growth Factors in Short Bowel Syndrome. IN: Buchman, A., ed. Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 383-394.

This chapter about the use of growth factors in short bowel syndrome (SBS) is from a comprehensive textbook that compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders that affect the gastrointestinal (GI) tract. SBS as a specific form of intestinal failure resulting from inadequate length of functional small bowel. The syndrome is characterized by a failure to meet the body’s need for calories and macro- and micronutrients via the enteral route. The author describes factors responsible for the morphological and functional changes in the adaptive processes and presents results of clinical trials that use either growth hormones or glutamine and glucagon-like peptide (GLP)-2 in patients with SBS. Topics include the interplay between SBS, intestinal failure, and intestinal adaptation; factors responsible for morphological and functional changes, including direct actions of luminal nutrients and pancreaticobiliary secretions, and enteric hormones; hormonal stimulation of intestinal adaptation; and related clinical studies on wet-weight absorption, energy absorption, body weight, composition, and urine creatinine excretion. The author concludes that the presence and severity of adverse events is a concern when considering long-term pharmacological growth-hormone treatment to promote hyperadaptation in short bowel patients. Adverse events of the use of growth-hormone in SPS patients can include myalgias, arthralgia, gynecomastia, carpal tunnel syndrome, nightmares, and insomnia, any of which may have a negative impact on the patient’s quality of life. 1 figure. 113 references.

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Acute Mesenteric Venous Thrombosis. In: Kelly, K.A.; Sarr, M.G.; Hinder, R.A., eds. Mayo Clinic Gastrointestinal Surgery. St. Louis, MO: Elsevier Science. 2004. p. 447-455.

Mesenteric venous thrombosis is a rare severe form of acute mesenteric ischemic (lack of blood flow in the main arteries of the intestines). The clinical presentation is frequently insidious; signs and symptoms of the disease may be nonspecific, and delay in diagnosis is frequent, resulting in substantial mortality. The main causes of death in this condition are bowel infarction with peritonitis leading to septic shock and short-bowel syndrome after extensive resection. This chapter on acute mesenteric venous thrombosis is from a book that focuses on the major diseases treated by gastrointestinal surgeons, from the esophagus to the anal canal. The presentation has a definite clinical orientation and a major emphasis on practical applications as they are applied at the Mayo Clinic. The authors of this chapter review the incidence, pathogenesis, and clinical presentation of acute mesenteric venous thrombosis. The authors discuss the difficulty in reaching an early diagnosis, review the accuracy of available imaging studies, and discuss nonsurgical and surgical treatment options and results. The authors conclude with an algorithm for optimal management of patients who have this potentially lethal condition. The chapter is illustrated with line drawings and black-and-white photographs. 7 figures. 4 tables. 52 references.

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