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Metrics details. Intestinal failure IF is a rare but severe form of organ failure. A broad spectrum of diseases, trauma and complications of surgery might eventually end up with intestinal failure. Nowadays, intestinal failure patients are preferably cared for in intestinal rehabilitation units IRU. Autologous gastrointestinal reconstruction AGIR refers to non-transplant operative management of IF patients designed to improve enteral tolerance and gut absorptive capacity. Herein we present five cases with complications of surgeries due to peptic ulcer bleeding, blunt abdominal trauma, obesity and gastric tumor. The surgeries were complicated by anastomotic leak, peritonitis and fistula formation.

By adopting multidisciplinary decisions and special care for each complication, all the Langer Article Critique patients were Langer Article Critique managed and discharged.

As presented, re-anastomosis in presence of abdominal contamination will probably fail. In patients with intestinal failure, PN should start as soon as possible to increase the success rate of future surgeries and prevent potential need for intestinal transplantation. We suggest referring patients with complicated outcomes of gastrointestinal surgeries to the IRUs to reduce morbidity and mortality. Peer Review reports. In Fleming et al. The major etiologies are reported to be iatrogenic as a complication of surgery, malabsorption syndromes, vascular events, trauma, intra-abdominal malignancies, congenital causes Langer Article Critique motility disorders [ 3 ].

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The mentioned conditions might result in IF with various mechanisms including short bowel syndrome SBSenterocutaneous fistula, mechanical obstruction, extensive mucosal disease and intestinal dysmotility [ 4 ]. One major cause of IF is surgical resection of the small intestine. The changes include increasing villi height and crypt depth, enterocyte and smooth muscle hyperplasia with consequent small intestine hypertrophy.

The adaptive changes will continue for months [ 56 ]. The aim of management of IF is to reduce complications, treat or alleviate the underlying disease, provide rational and proper intravenous supplementation and achieve a desirable quality of life for the patients [ 7 ]. Due to the chronic nature of underlying conditions of IF, possibility of numerous complications and long-term treatment, in most centers a multidisciplinary management has been adopted.

The visit web page team MDT includes surgeons, pharmacists, nutritionists, gastrointestinal specialists, trained nurses and various other experts. They provide a management Arrticle to shorten the hospital admission period, reduce the need for intestinal transplantation and advocate home parenteral nutrition PN [ 8 ]. Surgeons may Lxnger fistulas, take down stomas, elongate the small intestine and resect the diseased segments as various techniques of AGIR. By the help of AGIR, a greater mucosal area will be exposed to enteral material enhancing the adaptation process [ 9 ]. Furthermore; AGIR helps lower Langer Article Critique risk of bacterial overgrowth by reducing segmental intestinal dilatation [ 10 ].

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The hospital is the biggest center of solid organ transplantation in Criique and is affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The MDT consists of hepatobiliary surgeons as the head of the team, a clinical pharmacist assigned for designing and management of pharmacotherapy and PN, wound care specialists, expert nurses and registered dietitians.

In the current article we first briefly Langer Article Critique successful managements of five complex IF cases referred to our center, their history and outcomes.

Then, we provide surgical tips to prevent the primary mismanagements of these patients as follows. Previously healthy year-old gentleman presented to the emergency department ED complaining of hematemesis. After initial resuscitation with fluids, while hemodynamically stable, the patient underwent diagnostic and therapeutic upper gastrointestinal endoscopy, during which a bleeding duodenal ulcer was seen. The surgery LLanger Langer Article Critique called for an emergent laparotomy when the procedure was not successful in controlling the bleeding site.

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After hemostasis and doudenotomy, he was transferred to the Langer Article Critique. Few days later, he developed peritonitis due to duodenal suture leak. The patient underwent a secondary laparotomy for inserting a draining tube and was then transferred to our center for further management. Besides; a corrugated drain was inserted in the abdominal cavity Fig. On the second post-operation day, we noticed bile leakage via the corrugated Cgitique indicating failure of the jejunal serosal patch and ongoing bile leakage from the anastomotic site to the abdominal cavity.]