Two Cases of Short Bowel Syndrome Successfully Treated with Teduglutide Following Superior Mesenteric Artery Embolism

Abstract

A superior mesenteric artery (SMA) embolism blocks blood flow to the intestines, leading to intestinal necrosis. In such cases, surgical resection of the affected bowel is critical. However, accurate determination of the required extent of bowel resection under ischemic conditions can be challenging. If the patient survives the surgery, there is often a risk of development of short bowel syndrome (SBS), which severely impacts QOL due to decreased nutrient absorption. We encountered two cases in which patients developed SBS following surgery for SMA embolism at a higher-level hospital. Both patients were transferred to our care-mix hospital, where they received teduglutide treatment. Teduglutide is believed to support intestinal healing by promoting nutrient absorption, maintaining mucosal integrity, and aiding in intestinal repair. In both cases, this treatment resulted in significant improvement in intestinal absorption capacity, leading to a noticeable enhancement in QOL. One case, in particular, involved a patient who had been struggling with SBS complications for over a year. The patient was expected to have a poor prognosis due to severe malabsorption and associated complications. However, following teduglutide administration, the patient experienced dramatic improvements in nutrient absorption and was eventually able to be discharged home, marking a remarkable turnaround in their condition. These cases highlight the potential of teduglutide as an effective therapy in managing SBS and improving outcomes after extensive bowel resection.