Short Bowel Syndrome

Intestinal failure, sometimes referred to as “short bowel syndrome" or "short gut syndrome,” results from a number of causes ranging from surgical removal to functional failure to develop. UPMC Children's Hospital of Pittsburgh offers a unique approach to treating short bowel syndrome and is at the forefront of treating this medical issue. A multi-specialty group of pediatric experts from surgery, gastroenterology and transplant collaborate to evaluate the underlying diagnosis, nutritional needs and digestive functions. After evaluation, a patient may be recommended for a bowel-lengthening procedure.

Whether a portion of the intestine has been removed by surgery, has been damaged by physical trauma or has stopped developing or working, Children’s Hospital of Pittsburgh provides family-centered, innovative care. Both the patient and family are provided support and education as needed. The expert team dedicated to each patient evaluates all possibilities before determining a course of treatment. The goal of this unified approach improves liver function and nutritional absorption.

Bowel-lengthening Procedure

If a bowel-lengthening procedure is determined to be the best option, one of two procedures may be used, as described below:

  • Bianchi Procedure separates the intestine, converting one short large diameter length into a longer smaller diameter tube. This allows a longer length and more time for food to travel in the intestine, and therefore be absorbed by the digestive process. This may allow a child being fed intravenously to begin eating sooner on their own.
  • Serial Transverse Enteroplast Procedure (STEP) utilizes a stapling device to make small V-like patterns in the intestinal tract. This also narrows the diameter of the intestine by creating an accordion-like structure allowing food to spend more time in the intestine to be absorbed naturally.


In situations where a bowel-lengthening procedure will not be effective, a transplant may be recommended. Approximately 40 to 50 percent of short bowel syndrome patients are referred for transplantation. In addition, our surgeons exhaust all options before recommending transplantation.

As the nation’s first transplantation program, Children’s Hospital has been at the forefront of pediatric liver transplantation and intestine transplantation for over 25 years. Our pediatric intestine and liver transplant survival rates are among the highest in the world.