Intestinal failure is when a patient's native bowel is unable to digest and absorb the food, electrolytes, and fluids needed for normal growth and development.
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Clinical presentation
This often includes intractable diarrhoea, weight loss, dehydration, electrolyte imbalance, and malnutrition.
Pathology
Aetiology
Paediatric
- congenital malformation
- necrotising enterocolitis
- short bowel syndrome
- intestinal pseudo-obstruction
- microvillus inclusion disease
Adult
- short gut syndrome
- inflammatory bowel disease
- bowel fistulation
- familial colorectal polyposis
- desmoid tumours of the mesenteric root and retroperitoneum
Radiographic features
The role of imaging lies in identifying post-surgical bowel anatomy, congenital malformations, segmental disease involvement, measuring bowel length and identifying associated collections or other acute complications.
Treatment and prognosis
When related to acute infection or inflammation relevant medical treatment is combined with a period of total parenteral nutrition (TPN). In cases of fistula related intestinal failure, some cases may benefit from surgery including defunctioning stomas 3.
Long-term TPN via indwelling central venous catheters is used for patients with chronic failure. This is associated with significant long-term complications, and some patients may eventually undergo intestinal transplantation.
Multiple other surgical techniques including bowel lengthening, tapering and valve implantation have been described but remain controversial.
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