Abstract

 

Aim: Enteral nutrition in surgical patients is not only physiological but also cheap. On the contrary, parenteral nutrition is more expensive and has several complications. In this report, we present three different cases in which we had to administer long term parenteral nutrition but somehow could be managed by unique applications of enteral nutrition.

Patients and Methods: Three patients (one with pancreas cancer, one with gunshot wound and one with mesenteric vascular disease) were administered different types of enteral nutrition in the postoperative course, between the years 2002 and 2005. The first patient with an unresectable pancreas tumor underwent a hepaticojejunostomy and developed anastomotic leakage. This patient received enteral nutrition from a transhepatically placed jejunal catheter. The second one with mesenteric ischemia received enteral nutrition via a Foley catheter placed into the distal jejunostomy. And the third patient had a gunshot wound. He had persistant duodenal and jejunal multiple leakage with an open abdomen. This patient was also fed with a catheter placed into the distal small bowel. All patients underwent contrast radiographic tests in order to evaluate the patency of the gastrointestinal system prior to enteral nutrition.

Results: All postoperative problems could be managed by the advantages of enteral nutrition and the patients were discharged from the hospital uneventfully.

Conclusion: In complicated surgical patients, even though the conditions are tough, maximum effort must be done to use the enteral path for nutrition. This will not only minimize the risk for complications but also prevent mortality.

Key words: Enteral nutrition, Alternative nutrition, Postoperative nutrition.