[Reversal of intestinal segments for therapy of malabsorption after small bowel resection. Experiments on animals (author's transl)].

Following massive small bowel resection malnutrition occurs as a result of impaired digestion and malabsorption. Of the numerous methods of operation suggested to improve intestinal absorption only the reversal of intestinal segments seems to be promising. Since so far this method was used clinically only in single cases, the method was studied experimentally in 50 minipigs (divided in 4 groups: 90 p.c.-small bowel resection without reversal, with primary or secondary reversal, and normal controls). The reversed segments 5 or 10 cm in length were inserted in the middle or at the end of the remaining jejunum or ileum. In comparison with the animals without intestinal reversal the animals with reversed segments showed a significant increase of intestinal transit time and of absorptive capacity, a nearly normal weight development and a considerably better adaptation of the remaining small bowel. In contrast to that the animals without reversal showed after an average of 3 months extreme cachexia. These encouraging experimental results with reversed segments in short bowel syndrome justifies in our opinion the application of this therapeutic principle in humans.