HOME PARENTERAL-NUTRITION AFTER NEAR-TOTAL ENTERECTOMY

Six patients with extreme short bowel syndrome (4.2 +/- 4.9 cm of resi dual small bowel) were provided home parenteral nutrition (HPN) for 14 ,397 days. The average age at onset of HPN was 38 years (18-64 years). Patients maintained body weight at 97% of ideal (86-112%) with mean s erum albumin of 3.7 +/- 0.6 g/dL (normal 3.5-5.8 g/dL), serum transfer rin of 341 +/- 104 mg/dL (normal 200-400 mg/dL), and mean serum pre-al bumin of 27.5 +/- 12.6) mg/dL (normal 16.6-43 mg/dL). Hospital admissi on for HPN-related complications was required 10.3 times/patient for a total of 864 hospital days and was catheter related in 71% of episode s. Catheter sepsis occurred once per 436 catheter days and required ca theter removal in only 33% of instances. Five patients were able to re sume an oral diet, five had returned to work or school, and three were married with family. HPN allowed return to a quality productive life with acceptable morbidity following catastrophic massive bowel resecti on.