In a small retrospective single-center study (GC Ives et al. J Pediatr 2016; 178: 275-7), the authors found that small bowel diameter, as measured on calibrated luminal contrast studies was predictive of enteral autonomy.
Measurements of >35 mm of bowel lumen was considered dilated. 29 patients had adequate imaging for the study. Necrotizing enterocolitis was the most common etiology of short bowel syndrome in this study. 16 (55%) of the intestinal failure group achieved enteral autonomy in an average of 1.3 years. 11 (38%) of patients underwent an intestinal lengthening procedure.
- Small bowel diameter correlated negatively with residual small bowel length
- Larger small bowel diameter predicted failure to achieve enteral autonomy. In fact, only one patient in this study with a dilated small bowel diameter achieved enteral autonomy.
My take: Bigger (diameter) is not better.
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