Bowel Resections

Question 1

What is a SI resection?

Answer 1

When some of the small bowel is removed, it is usually well tolerated but if less than 1m, of small bowel in continuity it can lead to short bowel syndrome

Question 2

Tip for SI resection?

Answer 2

If jejunum is resected it is better tolerated than when the ileum is resected

Question 3

Clinical implications of ileal resection?

Answer 3

-Loss of ileal brake and ileocaecal valve 
= diarrhoea 
-Bile-salt induced diarrhoea
-Steatorrhoea/gallstone formation 
-Oxaluria & oxalate stones 
-B12 deficiency

Question 4

What happens in bile salt induced diarrhoea?

Answer 4

Bile salts and fatty acids enter the colon and cause malabsorption of water and electrolytes

Question 5

How are ileal resections managed?

Answer 5

Imaging of the small bowel 
Measurement of B12 
Bile salt retention test 
H breath test 
B12 replacement and low fat diet 
Colestyramine improves diarrhoea

Question 6

What may jejunal resection lead to?

Answer 6

Gastric hypersecretion with high gastrin levels

Increase in absorption per length

Question 7

What is a pro of jejunal resection?

Answer 7

Ileum can compensate for loss of absorptive function