K Thaler1, J Garreau, P D Hansen. 1. Department of Minimal Invasive Surgery, Legacy Health System, Oregon Health and Science University, Portland, Oreg, USA.
Abstract
BACKGROUND: Early enteral tube feeding is widely used after major surgery and trauma. This article is intended to alert surgeons to the possibility of small bowel necrosis following enteral refeeding and to discuss etiology and clinical features. METHODS: A case series from a single surgeon's database at a Tertiary Care Center is reported. Cases were drawnfrom a consecutive series of patients undergoing pylorus-preserving pancreaticoduodenectomy and placement of a needle catheter jejunostomy between January 1998 and June 2004. RESULTS: Two patients receiving early postoperative tube feeding developed sepsis with subsequent small bowel necrosis. Abdominal distension and signs of sepsis developed early postoperatively. Diagnosis was made based on characteristic computed tomography findings. Both patients underwent laparotomy with segmental bowel resection and survived. CONCLUSION: Non-specific septic symptoms associated with recurrent abdominal distension are ominous signs in patients receiving early postoperative enteral tube feeding and should prompt discontinuation of enteral nutrition. Within this scenario, CT imaging represents a valuable adjunct in the early assessment of these patients. Copyright (c) 2005 S. Karger AG, Basel.
BACKGROUND: Early enteral tube feeding is widely used after major surgery and trauma. This article is intended to alert surgeons to the possibility of small bowel necrosis following enteral refeeding and to discuss etiology and clinical features. METHODS: A case series from a single surgeon's database at a Tertiary Care Center is reported. Cases were drawnfrom a consecutive series of patients undergoing pylorus-preserving pancreaticoduodenectomy and placement of a needle catheter jejunostomy between January 1998 and June 2004. RESULTS: Two patients receiving early postoperative tube feeding developed sepsis with subsequent small bowel necrosis. Abdominal distension and signs of sepsis developed early postoperatively. Diagnosis was made based on characteristic computed tomography findings. Both patients underwent laparotomy with segmental bowel resection and survived. CONCLUSION: Non-specific septic symptoms associated with recurrent abdominal distension are ominous signs in patients receiving early postoperative enteral tube feeding and should prompt discontinuation of enteral nutrition. Within this scenario, CT imaging represents a valuable adjunct in the early assessment of these patients. Copyright (c) 2005 S. Karger AG, Basel.
Authors: Grant E O'Keefe; Marilyn Shelton; Joseph Cuschieri; Ernest E Moore; Stephen F Lowry; Brain G Harbrecht; Ronald V Maier Journal: J Trauma Date: 2008-12
Authors: S A Sethuraman; V K Dhar; D A Habib; J E Sussman; S A Ahmad; S A Shah; B J Tsuei; J J Sussman; Daniel E Abbott Journal: J Gastrointest Surg Date: 2017-09-27 Impact factor: 3.452
Authors: Omer S Al-Taan; Robert N Williams; James A Stephenson; Melanie Baker; S Murthy Nyasavajjala; David J Bowrey Journal: J Gastrointest Surg Date: 2017-06-23 Impact factor: 3.452
Authors: Duncan Rc Spalding; Kasim A Behranwala; Peter Straker; Jeremy N Thompson; Robin Cn Williamson Journal: Ann R Coll Surg Engl Date: 2009-06-25 Impact factor: 1.891