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Postoperatively, total parenteral nutrition was started and gradually replaced with oral supplements and refeeding of bowel contents. One week after discharge, the patient presented with features of severe dehydration and short bowel syndrome. After resuscitation and stabilisation, restoration of bowel continuity was performed. The patient developed the refeeding syndrome postsurgery, which was managed with micronutrient supplementation. This case highlights the challenges of managing a patient with short bowel syndrome, including timely surgical intervention, postoperative monitoring and appropriate nutritional management for the best outcome.<\/jats:p>","DOI":"10.1136\/bcr-2025-266578","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T01:20:17Z","timestamp":1753060817000},"page":"e266578","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Management challenges in a patient presenting with acute mesenteric ischaemia"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5061-0902","authenticated-orcid":false,"given":"Vikram","family":"Saini","sequence":"first","affiliation":[{"name":"Department of Surgical Discipline, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7243-206X","authenticated-orcid":false,"given":"Mahendra Pratap","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Surgical Discipline, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8547-7958","authenticated-orcid":false,"given":"Saikumar","family":"Kumbar","sequence":"additional","affiliation":[{"name":"Department of Surgical Discipline, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chitturi Bindu Devi","family":"Kalpana","sequence":"additional","affiliation":[{"name":"Department of Surgical Discipline, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,20]]},"reference":[{"key":"2025082709475659000_18.7.e266578.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1503884"},{"key":"2025082709475659000_18.7.e266578.2","doi-asserted-by":"crossref","DOI":"10.1186\/s13017-017-0150-5","article-title":"Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery","volume":"12","author":"Bala","year":"2017","journal-title":"World J Emerg Surg"},{"key":"2025082709475659000_18.7.e266578.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(97)89619-5"},{"key":"2025082709475659000_18.7.e266578.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2016.02.011"},{"key":"2025082709475659000_18.7.e266578.5","doi-asserted-by":"publisher","DOI":"10.1177\/0148607114520994"},{"key":"2025082709475659000_18.7.e266578.6","first-page":"591","article-title":"Short bowel syndrome: A review of pathophysiology, diagnosis, and treatment","volume":"32","author":"Klek","year":"2016","journal-title":"Nutrition"},{"key":"2025082709475659000_18.7.e266578.7","first-page":"1113","article-title":"The clinical management of short bowel syndrome","volume":"73","author":"Pironi","year":"2019","journal-title":"Eur J Clin Nutr"},{"key":"2025082709475659000_18.7.e266578.8","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1007\/s11605-018-3752-7","article-title":"Distal Bowel Re-feeding in Patients with Proximal Jejunostomy","volume":"22","author":"Nagar","year":"2018","journal-title":"J Gastrointest Surg"},{"key":"2025082709475659000_18.7.e266578.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a301"},{"key":"2025082709475659000_18.7.e266578.10","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1097\/SLA.0000000000001440","article-title":"Autologous Reconstruction and Visceral Transplantation for Management of Patients With Gut Failure After Bariatric Surgery: 20 Years of Experience","volume":"262","author":"Abu-Elmagd","year":"2015","journal-title":"Ann Surg"},{"key":"2025082709475659000_18.7.e266578.11","first-page":"732","article-title":"Nutritional management of short bowel syndrome: Total parenteral nutrition and beyond","volume":"27","author":"Buchman","year":"2012","journal-title":"Nutr Clin Pract"},{"key":"2025082709475659000_18.7.e266578.12","first-page":"412","article-title":"Small bowel transplantation: Advances, indications, and outcomes","volume":"31","author":"DeLany","year":"2018","journal-title":"Transpl Int"},{"key":"2025082709475659000_18.7.e266578.13","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/0140-6736(90)93238-K","article-title":"Jejunal efflux in short bowel syndrome","volume":"336","author":"Nightingale","year":"1990","journal-title":"The Lancet"},{"key":"2025082709475659000_18.7.e266578.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2018.08.002"},{"key":"2025082709475659000_18.7.e266578.15","unstructured":"Norbury WB , Situ E , Herndon DN . 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