How many feet of small bowel beyond the ligament of Treitz is typically considered for HPN coverage?

• A. ≤ 5 feet
• B. > 10 feet
• C. 6-9 feet
• D. 0 feet

Answer: (A)

Understanding the situation helps: after the ligament of Treitz, the small bowel’s ability to absorb nutrients depends on how much length remains. When only about five feet or less of small bowel are left beyond that point, absorptive capacity is often insufficient to meet nutritional needs, so home parenteral nutrition is typically considered. This five-foot threshold reflects a common clinical cutoff where reliance on parenteral support becomes necessary due to limited surface area for absorption. If more than five feet remains, some enteral absorption is usually possible, and PN is not automatically required; the actual decision still depends on functional factors like the presence of the colon, ileal function, and how well the bowel has adapted.