Extensive resections of the small bowel can now be performed with minimal immediate mortality. Surgeons no longer need to harbor great concern for the procedure itself but must recognize that the maintenance of adequate nutrition continues to be a serious problem. In cases of superior mesenteric artery occlusion, often a major portion of the small bowel and, frequently, the right half of the colon must be resected. Such patients, even if they survive surgery, usually die of starvation within months. It is a frustrating and helpless experience to watch an individual deteriorate because the bowel is unable to provide adequate utilization of ingested food.
The response to extensive resection of the small intestine in man is followed by a variable and unpredictable outcome. This depends upon the magnitude of the resection, the length and viability of the remaining bowel, the presence or absence of the ileocecal valve, and possibly a