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Nutrition clinique et métabolisme
Volume 14, n° 4
pages 273-279 (décembre 2000)
Doi : S0985-0562(00)80004-7
accepted : 21 September 2000
Le concept d'intestin dépassé
The overwhelmed intestine syndrome
 

Jacques Cosnes
 Service de gastroentérologie et nutrition, hôpital Rothschild, 33, boulevard de Picpus, 75571 Paris cedex 12, France 

Résumé

Certains patients ayant subi une résection étendue de l'intestin grêle développent une diarrhée majeure dépassant 2 kg par 24 heures, traduisant le dépassement des fonctions d'absorption résiduelle. L'analyse des pertes fécales en fonction des apports caloriques entéraux montre que les deux sont étroitement liés chez un même patient. On peut ainsi distinguer les patients ayant des pertes excessives obligatoires, élevées même si l'apport calorique entéral est modéré (syndrome de l'intestin dépassé obligatoire), et ceux n'ayant des pertes excessives que dans le cas d'un apport entéral trop élevé (syndrome de l'intestin dépassé induit). Dans ce dernier cas, l'autonomisation par voie entérale est habituelle, alors que les patients ayant un syndrome de l'intestin dépassé obligatoire justifient une nutrition parentérale prolongée voire définitive.

The full text of this article is available in PDF format.
Summary

After extensive small bowel resection, some patients develop a massive diarrhoea (daily faecal weight above 2 kg). Such massive faecal losses demonstrate that the residual absorptive capacities of the short bowel are overwhelmed. There is in each individual with a short bowel syndrome a correlation between daily faecal losses and daily enteral caloric intake. One can separate two different groups of patients: those who have massive faecal losses even when the enteral load is moderate (obligatory overwhelmed intestine syndrome) and those who develop massive faecal losses only when the enteral load is exceeding (induced overwhelmed intestine syndrome). In the latter patients autonomy via the enteral route is usual, whereas the former patients require prolonged or definitive parenteral nutrition.

The full text of this article is available in PDF format.

Keywords : grêle court, malabsorption

Keywords : malabsorption, short bowel




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