please explain
i think it is A, as in isolated atresia remaining gut mucosal integrity and motility is preserved
correct answer
C necrotizing enterocolitis
Intestinal failure or short bowel syndrome is the condition where there is either anatomic or functional loss of bowel absorptive capacity. These patients are dependent on parenteral nutrition at least initially, with the host of potential comorbidities (sepsis, renal impairment, central line complications, and liver disease (IFALD)) that can occur. Prior to the advent of PN in 1967, there was no chance at survival, however in the US now there are a large number of intestinal failure programs which work towards establishment of enteral autonomy and weaning off PN.
There are many etiologies that can lead to intestinal failure in infants, with short bowel syndrome being the most common. Three anatomical subtypes of SBS have been described:
1. Mid small bowel loss, intact colon, some ileal preservation, small bowel anastomosis
2. Small bowel resection with partial colonic resection and enterocolonic anastomosis
3. Small bowel resection with high output jeunostomy.
Of these three subtypes, type 1 has the best prognosis for intestinal adaptation, type 2 is the most common in neonates and infants, while type 3 is the most challenging to manage. Overall, jejunal resections are better tolerated than ileal.
The single most important prognostic factor for enteral autonomy is the length of remaining small intestine. Full term neonates have between 175-300 cm of small bowel, while 28 week olds are estimated to have 200 cm or less. If the intestinal length is similar, then the next most important factor, noted in multiple studies, was the etiology — NEC has been found to have a increased likelihood of establishing a PN-free life, and were better than atresia, gastroschisis or other causes.
