Intestinal Length and Adaptation in Neonates

Measurement and Adaptation

• Normal adult small intestinal length ranges from approximately 275 cm to 850 cm when measured from the duodenojejunal flexure, with women typically having shorter lengths 1
• Intestinal length should be measured along the unstretched antimesenteric margin after dividing mesenteric attachments 2, 3
• Laparoscopic measurement of small bowel length is inaccurate with substantial interindividual variability compared to measurement during laparotomy 4, 5

Risk Stratification

• Neonates at greatest nutritional risk include those with duodenostomy or jejunoileal anastomosis with ≤35 cm residual small intestine, jejunocolic or ileocolic anastomosis with ≤60 cm residual small intestine, or end jejunostomy with ≤115 cm residual small intestine 2