Motility disorders in children with intestinal failure: a national tertiary referral center experience

Audelia Eshel Fuhrer*, Stephanie Sukhotnik, Hadar Moran-Lev, Keren Kremer, Yoav Ben-Shahar, Igor Sukhotnik

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: Intestinal dysmotility (ID) problems are common in patients with pediatric-onset intestinal failure (IF) and short bowel syndrome (SBS), leading to significant morbidity and delays in the advancement of enteral nutrition (EN). We aimed to investigate the clinical features and complications of ID in children with IF and SBS. Methods: Retrospective chart review of all children with IF and/or SBS who required parenteral nutrition (PN) > 6 weeks or small-intestinal resection ≥ 50%. Patients were divided into SBS and non-SBS groups. SBS group was divided into two subgroups: with and without ID. Patients with ID were identified (clinically, radiologically and functionally) and analyzed with regard to demographics, intestinal anatomy, complications and outcomes (short and long term). Results: A total of 42 children with IF were treated in our institution during 2003–2022. In non-SBS group (n = 10), ID was the most common cause of IF (80%). SBS-group included 32 children; 18 children (56%) developed ID. The clinical profile of SBS-ID patients (vs SBS) was: female gender (56%), remaining small bowel length ≤ 55 cm, estimated residual small bowel ≤ 28% (p = 0.045) and absence of ICV (56%). Common symptoms of the SBS-ID group were: food intolerance (61%), abdominal distension (50%), vomiting (44%), malabsorption and severe constipation. Complications included FTT (67%) (p = 0.003), bacterial overgrowth with subsequent bloodstream infection (33%) (p = 0.75), and lactic acidosis (11%). Lengthening procedure (STEP) was performed in 11 SBS-ID patients (61%) (p = 0.002). In all patients, STEP operation “rescued” their dysfunctional intestine. Eight of these patients (73%) were weaned from TPN. Survival rate was 100%; however, one SBS-ID patient is a candidate for combined intestinal and liver transplantation. Conclusions: ID is the most common complication of SBS and is the most common cause of IF in non-SBS patients. ID has a high morbidity rate and various clinical manifestations. Successful treatment of these infants may be achieved with the use of tapering enteroplasty.

Original languageEnglish
Pages (from-to)1737-1743
Number of pages7
JournalPediatric Surgery International
Issue number12
StatePublished - Dec 2022


  • Enteral autonomy
  • Intestinal dysmotility
  • Intestinal failure
  • Short bowel syndrome (SBS)
  • Tapering enteroplasty


Dive into the research topics of 'Motility disorders in children with intestinal failure: a national tertiary referral center experience'. Together they form a unique fingerprint.

Cite this