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December 1, 1962

Segmental Reversal of Small Intestine After Massive Bowel Resection: Successful Case with Follow-Up Examination

Author Affiliations

Los Angeles

JAMA. 1962;182(9):952-954. doi:10.1001/jama.1962.03050480058015d

EXTENSIVE small-bowel resections are most frequently performed for mesenteric vascular occlusion and volvulus. In 1880, Koeberle reported the first successful massive intestinal resection. When more than 200 cm., or approximately 7 ft., of small intestine is removed, the resection is generally considered to be massive.

The immediate mortality is high and the majority of those who survive develop the short-bowel syndrome which often results in death. The term "short-bowel syndrome" refers to the clinical features of malabsorption such as diarrhea, steatorrhea, weight loss, anemia, hypocalcemia, hypomagnesemia, and hypoproteinemia. These features usually are not apparent if more than 100 cm. of normal upper small intestine remains, and it is rare for patients to recover with less than 50 cm. of proximal jejunum, but occasional survivors have been reported.

When more than 80% of the small bowel is resected in the dog, cachexia and death within 90 days are the rule.