Buradasınız

ÇOCUKLUK ÇAĞINDA KISA BARSAK SENDROMU İLE İLGİLİ DENEYİMLERİMİZ

Journal Name:

Publication Year:

Abstract (2. Language): 
Short bowel syndrome (SBS) is a disease of neonatal period which appears mostly after massive bowel resection or congenital short bowel. SBS is generally seen after massive bowel resection because of malrotation, volvulus, gastrochisis, intestinal atresia, and necrotising enterocolitis. The clinical outcome is affected by the remained bowel length, presence of ileocecal valve, motility of intestine, bowel adaptation and tolerance of nutrition. The nutrition regimen complicates as septicemia and liver failure. Results.- 20 patients were followed-up during the 20 year period in our institution. The mortality rate was 60%. In these patients the remained bowel length was under 30 cm and ileocecal valve was not present or removed during the surgery. Conclusion.- In the early years of pediatric surgery the most common reason of death was bacterial overgrowth and septicemia. In the last years TPN related septicemia and liver failure are the main problem. However the main reason of mortality is septicemia in our clinic.
Abstract (Original Language): 
Masif barsak rezeksiyonu sonucu ya da konjenital barsak kısalığına bağlı malabsorbsiyon olarak tanımlanan kısa barsak sendromu (KBS) daha ziyade yenidoğanlar ın bir hastalığıdır. En sık malrotasyon- volvulus, gastroşizis, intestinal atrezi, nekrotizan enterekolit nedeni ile uygulanan barsak rezeksiyonları sonrası ortaya çıkar. Kısa barsak sendromunda sonuç kalan barsak uzunluğu, ileoçekal valvin mevcudiyeti, barsak motilitesi, beslenmenin toleransı ile paralellik göstermektedir. Ayrıca sonuç parenteral beslenmenin getirdiği başlıca komplikasyonlar olan sepsis ve karaciğer yetmezliği ile de doğrudan bağlantılıdır. Kliniğimizde 20 yıllık period içinde 20 KBS’lu olgu takip ve tedavi edilmiştir. Mortalite %60 olarak saptanm ıştır. Kaybedilen olgularda çoğunlukla kalan barsak uzunluğu 30 cm altında ve ileoçekal valvi olmayan veya korunamayan olgulardır. Bu olgular Çocuk Cerrahisinin ilk yıllarında “bakteriyel over- growth” ve sepsise sekonder kaybedilirken son yıllarda total parenteral beslenmeye bağlı sepsis ve karaciğer yetmezliği bağlı kayıplar ön plana çıkmıştır. Halen kliniğimizde KBS’lu olgularda primer hasta kay ıp nedenimiz sepsistir.
100-104

REFERENCES

References: 

1. Celayir S, Sarımurat N, Ilıkkan B, Eray N,
Yeşildağ E, Yeker D. Bir kısa barsak olgusu. İst
Çocuk Klin Derg 1996; 31: 403-406.
2. Coran AG, Spivak D, Teitelbaum DH. An
analysis of the morbidity and mortality of shortbowel
syndrome in the paediatric age group. Eur
J Pediatr Surg 1999; 9: 228-230.
3. Mayr JM, Schober PH, Weibensteiner U, et al.
Morbidity and mortality of the short-bowel
syndrome. Eur J Pediatr Surg 1999; 9: 231-235.
4. Robinson MK, Ziegler TR, Wilmore DW.
Overview of intestinal adaptation and its
stimulation. Eur J Pediatr Surg 1999; 9: 200-
206.
5. Sarımurat N, Celayir S, Eliçevik M, Dervişoğlu
S, et al. Congenital short bowel syndrome
associated with appendiceal agenesis and functional
obstruction. J Pediatr Surg 1998; 33: 666-
667.
6. Wasa M, Takagi Y, Sando K, et al. Intestinal
adaptation in paediatric patients with shortbowel
syndrome. Eur J Pediatr Surg 1999; 9:
207-209.
7. Vanderhoof JA, Sharon M. Enteral and
parenteral nutrition in patients with shortbowel
syndrome. Eur J Pediatr Surg 1999; 9:
214-219.
8. Vanderhoof JA, Langnas AN. Short-bowel
syndrome in children and adults. Gastroenterology
1997; 113: 1767-1778.
9. Meehan JJ, Georgeson KE. Prevention of liver
failure in parenteral nutrition-dependent
children with short bowel syndrome. J Pediatr
Surg 1997; 32: 473-475.
10.Hancock BJ, Wiseman NE. Lethal short-bowel
syndrome. J Pediatr Surg 1990; 25: 1131-1134
11.Kurkchubasche AG, Rowe MI, Smith SD.
Adaptation in short-bowel syndrome. Reassessing
old limits. J Pediatr Surg 1993; 28:
1069-1071.
12.Shanbhogue LKR, Molenaar JC. Short bowel
syndrome. Metabolic and surgical management.
Br J Surg 1994; 81: 486-499.
13. Liefaard G, Heineman E, Molenaar JC, et al.
Prospective evaluation of the absorptive
capacity of the bovel after major and minor
resections in the neonate. J Pediatr Surg 1995;
30: 388-391.
14.Agustin JC, Vazquez JJ, Arnao DR, et al. Severe
short-bowel syndrome in children. Clinical
experience. Eur J Pediatr Surg 1999; 9: 236-244.
15. Schimp G, Feierl G, Linni K, et al. Bacterial
translocation in short-bowel syndrome in rats.
Eur J Pediatr Surg 1999; 9: 224-227.

Thank you for copying data from http://www.arastirmax.com