Ultra-short bowel syndrome after near-total small bowel resection for gangrenous gut due to superior mesenteric artery thrombosis: a case report.

Ultra-short bowel syndrome (USBS) is a rare and life-threatening condition defined by the retention of ˂30 cm of small intestine following resection. We report the case of a 53-year-old male who presented with gangrenous gut secondary to superior mesenteric artery thrombosis, necessitating near-total small bowel resection. The patient was left with ~15 cm of proximal jejunum and 10 cm of distal ileum, with a jejuno-ileal end-to-end anastomosis. He developed severe postoperative watery diarrhoea and required Total Parenteral Nutrition (TPN) via a peripherally inserted central catheter line. With careful multidisciplinary management, the patient achieved intestinal adaptation and was weaned off TPN ~6 weeks postoperatively. This case highlights the challenges of managing USBS in a resource-limited setting and demonstrates that survival with gut adaptation is possible even with very limited residual small bowel length, provided that experienced surgical care and nutritional support are available.