PURPOSE: The purpose of this study was to determine the mechanisms by which @entity1 with @entity30 develop @entity177 and, in particular, to assess the relative importance of severe @entity66 , repeated uncomplicated elective small intestine resection, and resection performed as a consequence of intra-abdominal septic surgical complications. METHODS: This was a retrospective analysis of 41 @entity1 with @entity30 referred to a specialized @entity177 unit between January 1987 and September 1998 for permanent home parenteral nutrition. To compare the surgical activity in @entity1 groups, a resection index was calculated by dividing the number of intestinal resections by the interval in years between the first resection for @entity30 and referral for management of @entity177 . RESULTS: Extensive primary @entity30 was responsible for @entity177 in 7 cases (17 percent). The remainder (n = 34, 83 percent) developed @entity177 after intestinal resection. Nine of the "surgical" @entity30 @entity1 developed @entity177 after uncomplicated sequential resection, (median small-bowel length 65 (range, 60-120) cm) after a median of 3 (range, 2-8) operations over a median of 17 (range, 3-27) years. By contrast, the other 25 surgical @entity30 @entity1 developed @entity177 after multiple unplanned laparotomies for @entity1320 (median small-bowel length 70 (range, 60-200) cm), with a median of 4 (range, 2-7) laparotomies performed over a median of 0.5 (range, 0.1 to 1.5) years (P < 0.001). The resection index for the 25 @entity30 @entity1 undergoing laparotomies for @entity1320 was significantly greater than that of the 9 @entity1 who had planned sequential resections (2.1 (0.27-25) vs. 0.23 (0.1-1.0); P < 0.002, Mann-Whitney U test). CONCLUSION: Intestinal failure develops in @entity30 primarily as a result of complications of surgical treatment. The largest group of @entity1 at risk consists of those who are undergoing multiple unplanned laparotomies to control @entity1320 .

Mechanisms of @entity177 in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity66 :: ('MESH:D004194', 'Disease') :: ['primary disease'] @entity177 :: ('MESH:D051437', 'Disease') :: ['intestinal failure'] @entity1320 :: ('MESH:D059413', 'Disease') :: ['intra-abdominal sepsis'] @entity30 :: ('MESH:D003424', 'Disease') :: ["Crohn's", "Crohn's disease"]
@entity30 :: (MESH:D003424,Disease) :: ['Crohn's disease']
