PROSPECTIVE EVALUATION OF THE ABSORPTIVE-CAPACITY OF THE BOWEL AFTER MAJOR AND MINOR RESECTIONS IN THE NEONATE

The outcome after major bowel resection in the neonatal period depends primarily on the time needed for bowel adaptation. A prospective stud y was begun in neonates after small bowel resection to evaluate the ab sorptive capacity of the bowel and growth parameters as a result of ad aptation of the bowel. Twenty-four neonates who underwent bowel resect ion were included. The underlying diagnoses were necrotising enterocol itis (12), jejunal atresia (3), meconium peritonitis (3), and other (6 ). During the study, a standardized treatment with respect to nutritio n was followed. At predetermined times, enterostomy fluid or faeces we re collected for analysis of carbohydrate content, fat content, and fa tty acids, together with a xylose test and a hydrogen breath test. Gro wth parameters included weight and height. The 24 patients were divide d into two groups. Group A consisted of eight patients with short bowe l syndrome (defined as loss of more than 50% of the original small bow el length related to gestational age). The mean remaining small bowel length in this group was 34.0% (24% to 42%). Group B consisted of 16 p atients who had only minor bowel resections. Retarded growth was obser ved in four group A patients. Low levels of carbohydrate absorption we re found 2 and 4 weeks after the initial operation in group A, and 2 w eeks after the initial operation in group B. Low levels of fat absorpt ion were found 4 and 8 weeks after the initial operation in group A. T he coefficient of absorption of the different fatty acids showed compl ete absorption of caprylic acid. The first results of this prospective study provide new data regarding the absorptive capacity of the remai ning bowel after minor and major resections in an attempt to analyse t he process of intestinal adaptation. Copright (C) 1995 by Saunders Com pany