The small intestine is composed of three parts: duodenum, jejunum, and ileum respectively. A surgical resection involves removal of a part or all of an organ or structure and reattaching of whatever portion is not diseased, obstructed, perforated or gangrenous.

The causes may be related to malignant or benign conditions. Benign conditions that may indicate a need for resection because they could cause obstruction, perforation, gangrene or disease in the small intestine include lipomas, neurofibromas, leiomyomas, hemangiomas, Meckel's diverticulum, Crohn's disease (regional enteritis), and arteriovenous malformations.

Malignant conditions that may indicate a need for resection because they could cause obstruction, perforation, gangrene or disease in the small intestine include: adenocarcinoma; carcinoid tumors; Kaposi's sarcoma; lymphocytic leukemia; and lymphomas.

Manifestations depend upon the extent and location of the resection. In general, resection for benign or malignant tumors may result in diarrhea, decreased fat absorption, fluid and elecrolyte imbalances, gastric hypersection (hypergastrinemia), kidney stone formation, increased incidence of gallstones, and malabsorbtion of vitamins, minerals and carbohydrates.

Diagnostic studies following a resection will relate to signs and symptoms. The patient may need laboratory examinations to monitor the postoperative conditions of hypoalbuminemia; hypovolemia; loss of potassium, calcium, and magnesium; vitamin deficiencies; and metabolic acidosis. There will be a bowel adaptation period for up to 2 years.

Surgical resection is the treatment for lesions of the small intestine.

Resection of small bowel disorders may result in a return to normal bowel function if the surgery is a limited resection for benign conditions. Otherwise, short bowel syndrome is likely to be a residual, especially if over 75% of the small intestine is resected. Resection of small bowel malignant tumors will require follow-up for possible metastases.

• None.

• Where residual adhesions constitute the predominant disability, rate under diagnostic code 7301.

• Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation. [38 CR 4.114]

• There are diseases of the digestive system, particularly within the abdomen, which, while differing in the site of pathology, produce a common disability picture characterized in the main by varying degrees of abdominal distress or pain, anemia and disturbances in nutrition. Consequently, certain coexisting diseases in this area, as indicated in the instruction under the title “Diseases of the Digestive System,” do not lend themselves to distinct and separate disability evaluations without violating the fundamental principle relating to pyramiding as outlined in 38 CFR 4.14.  [38 CFR 4.113]

• For purposes of evaluating conditions in 38 CFR 4.114, the term “substantial weight loss” means a loss of greater than 20 percent of the individual's baseline weight, sustained for three months or longer; and the term “minor weight loss” means a weight loss of 10 to 20 percent of the individual's baseline weight, sustained for three months or longer. The term “inability to gain weight” means that there has been substantial weight loss with inability to regain it despite appropriate therapy. “Baseline weight” means the average weight for the two-year-period preceding onset of the disease. [38 CFR 4.112]