Intestinal Failure

An interactive discussion about intestinal failure between Todd Ponsky, MD and Brad Warner, MD. Dr. Warner is is the Jessie L. Ternberg, MD, PhD Distinguished Professor of Pediatric Surgery at Washington University School of Medicine and surgeon-in-chief for St. Louis Children’s Hospital in St. Louis, Missouri. Table of Contents 00:00 - Introduction 01:39 - What is intestinal failure? 02:50 - Required bowel length 05:39 - Nature history of short gut 07:07 - Mortality in intestinal failure 07:39 - Small bowel transplant candidacy 09:15 - Causes of short gut 09:42 - Medical management of short gut syndrome 12:40 - Primary prevention of TPN cholestasis 16:15 - Summary of medical management 18:03 - Importance of breast milk 19:19 - Formula selection 20:13 - Management of volume administered 21:47 - Surgical management of intestinal failure 24:21 - Surgical evaluation 27:26 - Surgical options 28:47 - Bowel lengthening procedures 29:59 - Bianchi procedure 31:45 - STEP procedure 36:07 - Bianchi procedure pearls 38:10 - Role of tapering 38:43 - Secondary prevention of TPN cholestasis 40:16 - Medical management of intestinal bacterial overgrowth 43:39 - Role of growth factors 46:34 - Intestinal transplant 49:33 - Management of central line-associated infections 50:06 - Intestinal transplant as last resort Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/