A rare case of short bowel syndrome combined with mechanical ileus due to numerous strictures of duodenum, a large part of the small and a half of the large bowel complicating radiotherapy after radical right nephrectomy for Wilms tumor 31 years ago was reported. The proximal 60cm of the jejunum were preserved only. A by-pass latero-lateral isoperistaltic retro-colonic gastrojejunoanal anastomosis was performed in combination with antiperistaltic interposition of 15cm of intact large bowel between the first proximal 40cm and the distal 20cm of the intact jejunum. The distal part of the intact jejunum was included in an isoperistaltic latero-lateral anastomosis with a normal colon segment. The success of the operative intervention depends on patient's age, intestinal residual, the presence of pre-stenosis dilatation, intestinal function and correctly selected surgical method to maintain the energy balance in the organism with oral feeding only.
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