Abstract Ref Number = APCP875
LONG TERM MONITORING IN CHILDREN WITH SHORT BOWEL SYNDROME POST LAPAROTOMY DUE TO INTESTINAL MALROTATION A CASE REPORT
Herka Putra,Julius Anzar,Moretta Damayanti,Ria Mareza
University of Sriwijaya Medical School Dr Mohammad Hoesin General Hospital Palembang
Background : Short bowel syndrome (SBS) is uncommon but highly morbid condition. It is a malabsorption condition caused by a surgical removal of large section of the intestine. Nutritional management in short bowel syndrome is complicated because of the extensive time required for a gradual process of fluid management, from parenteral to enteral nutrition
Case Presentation Summary : A 2 month-old-boy, weight 2600 g, body length 48 cm (WAZ -5.23, LAZ -5.22, WHZ -1.43) came with chronic diarrhea. There was a history of intestinal resection of 100 cm starting from Treitz ligament due to intestinal malrotation at age 30 days. During 2 weeks hospitalization, extensively hydrolyzed formula was administered by enteral feed and the body weight increased 200 g. Follow up at outpatient clinic at age 6 months found that patient still had diarrhea, but the WAZ improved to -1,91. The extensive hydrolyzed formula was changed to standard infant formula, thus we started to give complementary feeding and monitor for its efficacy and tolerance. Since the age of 9 months the diarrhea rarely happened and the WAZ at 9 and 12 months were -1.12and -0.34 respectively. At age of 1 year, body weight increased to 9300 g and body length 73 cm (WAZ -0.34) and diarrhea had completely ceased. We started to give the family meal and at age 24 months the body weight was 11 kg and height 86 cm, the patient became well nourished, with WAZ -0,87, LAZ -0,60, WHZ -0.81. No developmental problem was detected during our observation, all milestones were achieved at appropriate age.
Learning Points/Discussion : Nutritional support in SBS patient is very important. Most patient suffers from malabsorption and has to be given formula for special medical purposes. Long term monitoring has to be done to monitor nutritional and developmental status
Keywords: Short Bowel Syndrome Malabsorption Extensive Hyrolyzed Formula