Necrotizing enterocolitis (NEC) is one of the most common causes of short bowel syndrome in children. The prognosis of regaining intestinal function, weaning from parenteral nutrition and survival depend on multiple factors such as the remaining small intestinal length, the presence of ileocecal valve and overall intestinal adaptation. At present, more children with surgical short gut could transit to full enteral feeding. The minimal length of intestine to maintain full enteral autonomy has not been reported. We present the case of a preterm baby who developed short bowel syndrome as a result of surgical management of NEC. With a remaining small intestinal length of 10 cm, she was dependent on parenteral nutrition for 2.5 years. She suffered multiple episodes of catheter related bloodstream infection and thrombosis. Ultimately she was able to achieve complete enteral autonomy. Current surgical and nutritional management increases the survival rates and incidence of long-term intestinal autonomy even in the very short bowel patients. The presented case is an example of a surgical short bowel syndrome child and an optional surgical treatment for necrotizing enterocolitis to encourage pediatric surgeons to not lose hope in caring for these babies.

Keywords: Short bowel syndrome, necrotizing enterocolitis, intestinal autonomy