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Case Reports in Surgery
Volume 2014, Article ID 387307, 3 pages
http://dx.doi.org/10.1155/2014/387307
Case Report

A Short Bowel (Small Intestine = 40 cm), No Ileocecal Valve, and Colonic Inertia Patient Works Well with Oral Intake Alone without Parenteral Nutrition

1Department of Nutrition, Tainan Sin-Lau Hospital, No. 57, Section 1, Dongmen Road, Tainan City 70142, Taiwan
2Department of Surgery, Tainan Sin-Lau Hospital, No. 57, Section 1, Dongmen Road, Tainan City 70142, Taiwan
3Department of Nursing, Tainan Sin-Lau Hospital, No. 57, Section 1, Dongmen Road, Tainan City 70142, Taiwan
4Department of Life Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, No. 1, University Road, Tainan City 701, Taiwan

Received 6 April 2014; Revised 16 May 2014; Accepted 5 June 2014; Published 15 June 2014

Academic Editor: Boris Kirshtein

Copyright © 2014 Ming-Yi Liu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present a 50-year-old male who suffered from ischemic bowel disease, having undergone massive resection of small intestine and ileocecal valve. He had to cope with 40 cm proximal jejunum and 70 cm distal colon remaining. In the postoperative period parenteral nutrition (PN) was used immediately for nutrition support and electrolyte imbalance correction. We gave him home PN as regular recommendation for the short bowel status after discharge from hospital. This patient has tolerated regular oral intake 2 months later and did not develop significant short bowel syndrome. There were several episodes of venous access infection which troubled this patient and admitted him for treatment during home PN. Therefore, we changed home PN to cyclic tapering pattern. The patient could maintain his nutrition and hydration with oral intake alone after tapering home PN 15 months later. He has survived more than one year without PN support and still maintained 80% ideal body weight with average albumin of 3.5 ± 0.2 mg/dL. Although patient was hospitalized every two months to supplement nutrients, however, this has greatly improved the quality of life.