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Gastroenterol Clin North Am. 2019 Dec;48(4):483-498. doi: 10.1016/j.gtc.2019.08.003. Epub 2019 Oct 4.

Etiology and Medical Management of Pediatric Intestinal Failure.

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Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University College of Medicine, Center for Intestinal Rehabilitation and Nutrition Support, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. Electronic address:
Division of Gastroenterology, Hepatology and Nutrition, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
Division of Gastroenterology, Hepatology and Nutrition, Feinberg School of Medicine, Northwestern University, The Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Box 65, Chicago, IL 60611, USA.


Pediatric intestinal failure occurs when gut function is insufficient to meet the growing child's hydration and nutrition needs. After massive bowel resection, the remnant bowel adapts to lost absorptive and digestive capacity through incompletely defined mechanisms newly targeted for pharmacologic augmentation. Management seeks to achieve enteral autonomy and mitigate the development of comorbid disease. Care has improved, most notably related to reductions in blood stream infection and liver disease. The future likely holds expansion of pharmacologic adaptation augmentation, refinement of intestinal tissue engineering techniques, and the development of a learning health network for efficient multicenter study and care improvement.


Parenteral nutrition; Pediatric intestinal failure; Short bowel syndrome


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