There are numerous definitions for short-bowel syndrome (SBS).
The simplest definition is that there is inadequate intestine to
maintain normal nutrition by eating. Because infants and
children require increased calories to grow and develop, SBS can
have a more devastating effect in these patients. Before the
availability of total parenteral nutrition (TPN, food delivered
into the veins), most infants and children with SBS died from
malnutrition. The true incidence of SBS is unknown. A Canadian
study suggested that it is present in 4.8 per 1 million people.
SBS typically is the result of a catastrophic event involving
the small intestine and possibly the colon (large intestine).
Necrotizing enterocolitis and midgut volvulus from malrotation
are the two most common causes of SBS. Other causes are listed
in Table 1. The small intestine is completely formed by 20
weeks’ gestation. Most of its growth prior to birth occurs in
the third trimester. Before 27 weeks’ gestation, the average
length of the small intestin