Short Bowel Survivor & Friends

Antonino Morabito

Prof. Antonino Morabito MD, FRCS (Ed), FRCS (Eng), FICS

Consultant Specialist Neonatal and Paediatric Surgeon Honorary Senior Lecturer University of Manchester - School of Medicine

I am a Consultant Pediatric and Neonatal Surgeon working at Royal Manchester Children's Hospital. My undergraduate training was at Perugia in Italy, and my postgraduate training at Bologna, Italy and Manchester, UK under Mr. Adrian Bianchi.

My main interest is the management of children with congenital anomalies of the gastrointestinal tract, the abdominal wall and short gut problems. I have been involved in the specialist management of children with short gut for more than 10 years. I have many publications and have presented internationally on the management of short bowel state.

Surgery
Short bowel state is a potentially life threatening condition that requires a multidisciplinary approach.

The loss of small bowel may lead to inadequate absorption of nutrients and dependency on parenteral nutrition (TPN) - food by an intravenous drip. This can result in frequent and prolonged hospitilisation. The absence of an efficient bowel-liver circulation in these patients is responsible for repeated infections limiting access for giving TPN. TPN can also be toxic to liver cells sometimes causing liver failure.

There are two main aims for surgery in short bowel patients:

  • 1) to allow life without TPN

      • 2) to reduce dependency on TPN therefore reducing the risk of liver problems and the

        •   need for a small bowel transplant in the event of liver failure.

          Short bowel patients suffer from bowel dilatation and this is key for intestinal rehabilitation. The aim of surgery is to optimize the function of the remaining bowel by slowing down the passage of food allowing more nutrients to be absorbed, increasing the absorptive surface and improving the mechanical function. The results are encouraging and there are increasing numbers of patients who are no longer dependant on TPN following these operations.

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