The short bowel syndrome is a multifactorial disease that requires an intensive treatment especially if complication develop. The authors report their experience in a patient who, affected by acute renal failure after extensive intestinal resection, underwent temporary jejunostomy. The treatment of choice in this patient was initially a careful hydroelectrolytic balance, as he was in good nutritional status but underwent a dialytic treatment and jejunostomy. Then we started the nutritional support and initially we adopted enteral nutrition in order to facilitate small bowel functional integrity, avoid gastric uremic lesions and bacterial translocation which could prelude to multiple organ failure. At surgery we tried to preserve the distal ileum which is very important in order to absorb biliary salts and nutritional mixtures. Cholecystectomy was associated due to gangrenous cholecystitis probably caused both by short bowel syndrome and prolonged artificial nutrition. Six months after surgery the patient underwent a decrease of the body weight and then authors verified the stabilization of the weight and general conditions.