Successful treatment with teduglutide in short bowel syndrome with intestinal failure secondary to small-bowel volvulus: a case report and literature review.
Teduglutide may enable patients with severe short bowel syndrome to stop parenteral nutrition and improve their gastrointestinal symptoms, but this is based on a single case report.
Where it sits
this study against the rest of the teduglutide corpusSummary and findings
This case report discusses a 70-year-old man with severe short bowel syndrome (SBS) due to small-bowel volvulus who was treated with teduglutide. After 4 months of treatment, the patient was able to completely discontinue parenteral nutrition (PN) and experienced improvements in stool consistency and frequency. Notable improvements in quality of life (QoL) were also reported.
Abstract
<h4>Introduction and importance</h4>Short bowel syndrome (SBS) is a major cause of intestinal failure (IF). Patients with SBS-associated IF (SBS-IF) often require long-term parenteral nutrition (PN) and suffer from complications that impair quality of life (QoL), including severe diarrhea, weight loss, sleep disturbances, and catheter-related bloodstream infections (CRBSIs). Teduglutide, a glucagon-like peptide-2 analog, enhances intestinal adaptation and reduces dependence on PN. However, evidence in patients with ultra-short residual bowel remains limited, particularly in Japan. We report a case of severe SBS-IF in which teduglutide enabled complete weaning from PN and substantial QoL improvement.<h4>Case presentation and clinical discussion</h4>A 70-year-old man underwent an emergency, extensive small-bowel resection for small-bowel volvulus, leaving approximately 20 cm of small intestine with the colon in continuity. He developed SBS-IF requiring home PN and experienced watery diarrhea (more than 10 times per day), weight loss, sleep disturbance, and recurrent CRBSI. Four years after surgery, teduglutide was initiated. Within 4 months, stool consistency improved, bowel frequency decreased to 3-5 times per day, and absorption improved, allowing complete discontinuation of PN. Body weight stabilized, CRBSI resolved, and disease-specific QoL improved markedly.<h4>Conclusion</h4>Even in ultra-short-bowel SBS-IF, teduglutide may achieve PN independence and clinically meaningful improvements in gastrointestinal symptoms, weight maintenance, and QoL.
Background
Not reported in abstract.
Methods
Not reported in abstract.
Results
Not reported in abstract.
Interpretation
Not reported in abstract.
Limitations
Not reported in abstract.