Skipped Aganglionic Lengthening Transposition (SALT) is highly effective to achieve enteral autonomy in selected patients with intestinal failure secondary to total intestinal aganglionosis
Topic overview
This case series demonstrates that Skipped Aganglionic Lengthening Transposition (SALT) successfully achieved enteral autonomy in two pediatric patients with total intestinal aganglionosis and intestinal failure. Both patients were weaned from parenteral nutrition after SALT increased their functional bowel length by interposing aganglionic segments.
Key takeaways
- SALT procedure increased functional bowel length by 10-35% in total intestinal aganglionosis patients, enabling PN weaning.
- Patient #1 achieved complete enteral autonomy 28 months post-SALT with 35% length increase using three aganglionic loop interpositions.
- Complications include stricture formation requiring loop excision, as seen in Patient #2 who needed removal of 2/4 interposed segments.
- SALT may offer alternative to transplant for total aganglionosis patients with ≥20-30 cm ganglionated jejunum at birth.
- Mechanism combines increased absorptive surface with slowed transit time through strategically placed aganglionic segments.
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How to cite: GlobalCastMD. Skipped Aganglionic Lengthening Transposition (SALT) is highly effective to achieve enteral autonomy in selected patients with intestinal failure secondary to total intestinal aganglionosis. GlobalCastMD Medical Library. 2024-03-16. https://dev.library.globalcastmd.com/article/8404?via_space=staycurrentmd
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