Murat DEMİR, Işıl ALADAĞLI, Baki EKÇİ, Ali Levent IŞIK, Ali BEKRAKİ, Ahmet AŞKAR, Hüseyin KILAVUZ, Derya SELAMOĞLU
Cerrahpaşa Medical Journal - 2026;50(1):1-6
Objective: Short bowel syndrome (SBS) is a severe malabsorptive condition often resulting from extensive resection due to mesenteric ischemia. This study aimed to evaluate the clinical characteristics, intraoperative findings, and outcomes of patients with acute SBS secondary to mesenteric vascular pathology. Methods: This retrospective study analyzed adult patients treated at a tertiary referral center between September 2020 and September 2025. Inclusion criteria were defined as intestinal resection due to ischemic vascular causes resulting in a residual small bowel length of <=200 cm. Demographics, comorbidities, surgical details (ileocecal valve status, colon continuity), and total parenteral nutrition (TPN) dependence were evaluated. Results: Twenty-eight patients were included (mean age: 61.61 +/- 16.24 years; 60.71% male). Most patients (78.57%) were referred from other centers. Common comorbidities included hypertension (57.14%) and diabetes mellitus (35.71%). The predominant etiology was superior mesenteric artery embolism (67.86%). The median remaining small bowel length was 150 (IQR: 112.5-180) cm in all patients. The in-hospital mortality rate was 32.14%. Comparative analysis revealed no significant differences between mortality and discharge groups regarding age, ileocecal valve preservation, or colon continuity. However, patients independent of TPN at discharge had a significantly greater residual small bowel length compared to TPN-dependent patients (P < .05). Conclusion: Acute SBS secondary to mesenteric ischemia is associated with high mortality. While anatomical factors such as valve preservation did not predict short-term survival in this cohort, residual small bowel length was a significant determinant for TPN independence at discharge. Early diagnosis, timely revascularization, and careful perioperative management remain crucial to improving survival rates in this high-risk population.
