Short bowel syndrome is defined as the small bowel functional absorptive surface inability to provide adequate nutrition, leading to intestinal failure and chronic malnutrition. In adult individuals the main etiologies for short bowel syndrome are related to extensive or multiple surgical bowel resections secondary to mesenteric ischemia, Crohn’s disease and actinic enteritis. Besides evaluating the transit time through the large bowel, barium follow through may be utilized in the measurement of bowel remnants length as well as in the follow-up of structural adaptation phenomena of small bowel and colonic loops. In patients with short bowel syndrome, structural small bowel adaptation consists in hyperplasia of villi and mucosal folds, which become more numerous, deeper and larger in diameter, as well as remnant segment dilation. Such morphological findings are more prominent and best established in the ileal loops, whose remarkable adaptive capacity has been well documented. Therefore, the knowledge of imaging findings regarding morphological and adaptive characteristics of the small bowel is extremely relevant in the multidisciplinary approach to short bowel syndrome.

Keywords: Short bowel syndrome; Radiology; Adaptation.