Outcomes of Children With Short Bowel Syndrome: Experiences in a Multidisciplinary Intestinal Rehabilitation Unit Over Two Decades

Infographic · Mar 2025 · 1 min read

In brief

Twenty-year retrospective study of 64 children with short bowel syndrome shows 89% survival and 78% weaned off parenteral nutrition through multidisciplinary intestinal rehabilitation. Fish oil-based PN introduction in 2007 significantly improved outcomes, with IFALD and pre-2007 management predicting mortality.

78% of pediatric SBS patients achieved enteral autonomy with multidisciplinary intestinal rehabilitation over 8.9-year mean follow-up
IFALD and pre-2007 management (before fish oil-based PN) were significant predictors of mortality in pediatric SBS
Ultrashort bowel length predicted failure to wean from PN but was not associated with increased mortality
Introduction of fish oil-based PN in 2007 correlated with improved survival outcomes in pediatric SBS patients

Written by the GCMD Library team from the infographic.

A three-column comparison layout with icons representing different surgical procedures. Each column contains statistical data presented with percentage figures and bullet points. Color-coded sections distinguish between efficacy metrics (green tones) and complication rates (amber/red tones). Simple anatomical illustrations accompany each procedure type.

Jaime Tsz-Wing Tsang, Adrian Chi-Heng Fung, Stephen Cheuk-Lam Lau, Kenneth Kak-Yuen Wong

Background: Short bowel syndrome (SBS) is a rare but serious form of organ failure, and patients with SBS depend on total parenteral nutrition (PN) to maintain growth and development. The present study aimed to evaluate the experiences and outcomes of children with SBS managed by a multidisciplinary intestinal rehabilitation programme in a tertiary paediatric centre.

Methods: A retrospective single-centre analysis of all paediatric patients with a clinical diagnosis of SBS between 2001 and 2022 was performed. Clinical outcomes and their predictors were extracted and analysed.

Results: Of the 64 children included in the study, 43 (67%) had extensive necrotising enterocolitis. The median bowel length was 45 cm (interquartile range (IQR) = 18-65) and 18.9% (IQR = 10-28.5) of the expected length based on age. Over a mean follow-up period of 8.9 years, 57 patients (89%) survived, and 50 (78%) weaned off PN. The presence of intestinal failure-associated liver disease (IFALD) (OR = 6.375, p = 0.02) and patients managed before the introduction of fish oil-based PN in 2007 (OR = 5.895, p = 0.001) were significant predictors of mortality. There was an overall improvement in survival over time (p = 0.003). Ultrashort bowel length was not associated with significantly higher mortality (OR = 1.1, p = 0.65) but was a poor prognostic factor for weaning off PN (OR = 3.57, p = 0.004). Among all patients who weaned off PN, two had bowel lengthening procedures and one received a glucagon-like peptide 2 (GLP-2) analogue.

Conclusions: A multidisciplinary intestinal rehabilitation programme offers a comprehensive approach for patients with SBS and has been shown to be effective with favourable outcomes. Improvements in the choice of PN and the development of new treatment strategies potentially improved the survival and enteral autonomy of SBS patients.

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