Introduction: Concerning that the leading cause of short bowel syndrome in Asian countries is vascular events, unlike western countries which Chron’s disease lies at the top of the list, and also considering that most of these patients would die without proper management and planning, we had decided to design an algorithmic approach for managing these group of patients including years of experience in our country and also other pioneer studies of the field in other countries, by which we have fortunately come into promising results. Due to limited options and lacking HPN most surgeons in our country prefer resection and anastomosis, which had lead to an unfavorable result during past years. So we as the first small bowl rehabilitation and transplantation center in our country decided to design a comprehensive management guideline for this entity and having a categorized approach which includes, what should the first surgeon confronting this situation do at a local hospital and what would the next treatment plan be in a referral hospital, whether the patient needs more complex procedures as small bowel transplantation or reconstructive surgeries, or not.

Methods: A study group of the Intestinal Rehabilitation Unit (IFU) of Shiraz University of Medical Sciences, Iran was formed in 2018 with the aim of developing guidelines for the management of AMI. The evidence was then reviewed to answer these questions, and recommendations formulated.

Results: Regarding what mentioned in the article, mortality will decrease and a considerable number of patients will survive and by performing AGIR surgeries possible need for bowel transplantation will become less. The resultant recommendations are presented in this paper.

Conclusion: The aim of these guidelines is to provide recommendations for practice that will lead to improved outcomes for patients.