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Management of pediatric short bowel syndrome complicated by chronic kidney disease and secondary hyperparathyroidism: a case report from Japan
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Keita Takayama
 , Yuko Tazuke, Takeshi Kimura, Takeshi Ishimi, Koichi Deguchi, Kengo Nakahata, Motonari Nomura, Miho Watanabe, Takehisa Ueno, Hiroomi Okuyama
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Published online September 11, 2026
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DOI: https://doi.org/10.15747/ACNM.26.0068
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 Abstract
- A boy born at 24 weeks and 3 days of gestation, with a birth weight of 662 g, developed midgut volvulus secondary to intestinal malrotation at 3 months of age (reported corrected gestational age, 37 weeks). Extensive small-bowel resection and stoma creation left 20 cm of residual small intestine. He was transferred to our hospital for long-term nutritional management because of persistent liver dysfunction, jaundice, renal dysfunction, poor weight gain, and multiple fractures involving all four extremities. At admission, at 1 year and 3 months of age (reported corrected age, 7 months), he weighed 3.5 kg, and radiographs confirmed multiple extremity fractures. Laboratory testing showed malnutrition, hypocalcemia, renal dysfunction, and a markedly elevated serum parathyroid hormone concentration of 1,174.2 pg/mL. Secondary hyperparathyroidism was considered multifactorial, reflecting inadequate calcium availability due to short bowel syndrome together with coexisting chronic kidney disease. Calcium and phosphate supplementation were adjusted, and parenteral nutritional support was intensified. After 3 months, his weight had increased to 5.71 kg, and electrolyte abnormalities had improved. He was then discharged with home-based nutritional management.
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