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February 17, 1962

Loss of the Entire Jejunum and Ileum, and the Ascending Colon: Management of a Patient

JAMA. 1962;179(7):529-532. doi:10.1001/jama.1962.03050070000009b
Abstract

THE AMOUNT of small intestine required for survival is uncertain. Previous reports suggest that between 8 and 18 in. of small intestine below the ligament of Treitz is the minimal amount to support life, although we are aware of 3 exceptions.

The purpose of this presentation is to describe the clinical course of a patient whose entire jejunum, ileum, and ascending colon were removed because of necrosis secondary to mid-gut volvulus. From the management of this patient, a systematic, stepwise nutritional program was evolved which may be useful in the care of other patients with major loss of small bowel function.

Clinical History

A 21-year-old single male was admitted to the Burbank Hospital, Fitchburg, Mass., because of the acute onset of abdominal pain, nausea, and vomiting. Since birth he had been subject to recurrent episodes of vomiting and abdominal cramps, but no diagnosis had been made. During adolescence he attained

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