2025 Volume 59 Issue 2 Pages 61-65
We report a case of short bowel syndrome (SBS) treated with ω-3 fatty acid enteral supplementation (EPA1100 ®), which potentially prevented intestinal failure-associated liver disease (IFALD). The patient was a 2-year-and-7-month-old girl who underwent extensive bowel resection, including the ileocecal region, due to a 540-degree midgut volvulus associated with intestinal malrotation on the 24th day of life. A jejunostomy and ascending colostomy were created, leaving only 20 cm of small intestine. EPA1100 ® (0.27 g/kg/day) was administered on the 15th postoperative day, and she was transferred to our hospital at 4 months of age. The patient frequently developed catheter-related bloodstream infections, complicating the continuation of total parenteral nutrition (TPN) via a central venous catheter. After stoma closure surgery at 7 months of age, enteral nutrition gradually progressed, and TPN was discontinued at 14 months of age. She was discharged at 21 months of age and is currently doing well. Her bilirubin levels remained normal throughout hospitalization, and although there was a mild increase in liver enzymes, these values have since returned to the normal range. Blood levels of EPA and DHA fluctuated in accordance with the administered dose of EPA1100 ® per body weight. Intravenous fat emulsion was required when the T/T ratio was high. During the administration of EPA1100 ®, the patient did not exhibit clinical symptoms of essential fatty acid deficiency or bleeding tendency. EPA1100 ® was well absorbed from the intestinal tract, and in this case, nutritional management was successfully achieved without the development of IFALD. However, attention should be given to essential fatty acid levels in similar cases.
