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Background: Surgeons require accurate ranges of normal small bowel length (SBL) to benefit patients. The relationship between cadaveric SBL and in vivo human SBL is not known. We hypothesized that cadaveric SBL is significantly different compared to human SBL. Methods: SBL was measured prospectively in 167 formalin-fixed cadavers; and studied in 118 without intestinal surgery. A standardized and reproducible method of small bowel measurement was utilized in both in vivo and cadaveric subjects. Small bowel was measured in situ from the Ligament of Treitz to the ileocecal valve. These measurements were compared to previously published cadaveric and in vivo human SBL data. The number of cadavers examined was larger than in other published studies; the number of in vivo subjects was also the highest yet reported. Results: Formalin-fixed cadavers had significantly shorter SBL than living subjects366.1±82.7 vs 508.6±105.8 cm (mean + sd, p < 0.0001). The mean fresh cadaveric SBLs (592.8 cm) was longer in comparison to the formalin-fixed cadaver SBL (366 cm). In cadavers, univariate analysis showed that age (younger > older), height (taller > shorter), and gender (male > female) correlated with SBL (p < 0.01). In multivariate analysis, only height remained predictive of SBL (p < 0.0001). Torso length was positively correlated with SBL (cricoid to jugular notch, sternal angle, xiphoid, umbilicus, pubic tubercle), p < 0.0001 top = 0.005. Torso circumferences at the xiphoid-sternal angle, subcostal line, umbilicus, and iliac crest were all positively correlated with SBL (p = 0.005). Conclusion: To date, this study remains the first to compare detailed physical measurements to SBL. In vivo SBL was significantly longer than formalin-fixed cadaver SBL. Height was a primary predictor of SBL. Cadaveric SBL measurements should not be used to estimate normative SBL data in living subjects.

In Vivo Small Bowel Length is Longer than in Formalin-Fixed Cadavers