Short bowel syndrome classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Based on the length of the remaining bowel, short bowel syndrome may be divided into three types such as end-jejunostomy, jejunocolonic anastomosis, ileocolonic anastomosis. They have different progress from mild to severe dysfunction. All of them require home parenteral nutrition except ileocolonic anastomosis which has excellent prognosis and rarely needs parenteral nutrition. Based on the etiology, short bowel syndrome may be divided into three categories such as vascular abnormalities, mucosal disease of intestine and causes without preexisting intestinal disease.

Classification

• Based on the length of the remaining bowel, short bowel syndrome may be divided into three types:
  • End-jejunostomy (type I): Most severe form and less intestinal adaptation
  • Jejunocolonic anastomosis (type II): Greater degree of intestinal adaptation
  • Ileocolonic anastomosis (type III): Uncommon, excellent prognosis and parenteral nutrition is rarely needed
• Based on the etiology, short bowel syndrome may be divided into three categories:
  • Vascular abnormalities
    • Mesenteric vessel thrombosis 
    • Mesenteric vessel occlusion
    • Volvulus
    • Adhesions
    • Internal hernia
  • Mucosal disease of intestine
    • Crohn's disease
    • Radiation enteritis
  • Without preexisting intestinal disease
    • Malignancy
    • Jejunoileal bypass surgery to treat obesity
    • Trauma to the small intestine