P1.41: Double balloon enteroscopy reliably directs assessment for patients with short bowel syndrome.

Aim: To evaluated patients with short bowel syndrome(SBS) for determining extension of remnant intestine and aspect of the intestinal mucosal Methods: We retrospectively reviewed 20 patients who are at least 12 months in Home Parenteral Nutrition(HPN), included type III of intestinal failure characterized chronic condition, metabolic stable Of these patients divided in three groups: Nine had ultrashort bowel syndrome (USBS) characterized type I of SBS, nine had type II of SBS and two presented “no gut syndrome” We considered type I, patients with end-terminal jejunostomy and complex intestinal fistula as the same group. In case of the intestinal dilatation we collected intraluminal fluid for culture to diagnose bacterial overgrowth Results: The nine patients SBS type I group, the enteroscopy show us in the proximal intestinal mucosa with normal aspect and distal stump of the closed transverse colon, show severe ischemic colitis, except in one patient with mucosal fistula of colon The other nine patients of SBS type II group was observed intestinal stretching and dilatation, which caused difficulty in evaluating the length of the remnant intestine. In this group we diagnosis four cases of bacterial overgrowth and two cases of anastomotic ulcers in jejunum/transverse colon For the two cases of “ no gut syndrome” they have the fourth duodenal stumps closed with gastrostomy, we just observed the duodenum dilatation with some food waste Conclusion: Double balloon enteroscopy is a safe, reliable modality for determining changes in the intestinal mucosal and monitoring the intestine adaptation in SBS This technique can be used to direct selective surgical reconstruction of intestinal transit in pre-operative time