Khasawneh Faisal A, Al-Janabi Mohammed G, Ali Ahmad H
Section of Critical Care Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, Texas, USA.
BMJ Case Rep. 2013 May 23;2013:bcr2013009807. doi: 10.1136/bcr-2013-009807.
Enteral nutrition is the preferred route of feeding in critically ill patients. It has multiple advantages over parenteral nutrition and potentially improves patients' outcome. Enteral nutrition is delivered via gastric or postpyloric (small intestine) feeding tubes. The latter option used to be a more challenging choice to achieve unless the feeding tube is placed endoscopically or by interventional radiology. Multiple technical advances have facilitated postpyloric feeding, including a new electromagnetically visualised jejunal feeding tube system (CORTRAK Enteral Access System). We are presenting a case of a 50-year-old woman who suffered a nasopharyngeal perforation caused by this novel technology. The complication was recognised promptly and managed successfully with conservative measures. This case illustrates the importance of recognising patients at high risk for feeding tube placement complications, meticulous placement technique and appropriate follow-up once the tube has been inserted.
肠内营养是危重症患者首选的喂养途径。与肠外营养相比,它具有多种优势,并有可能改善患者的预后。肠内营养通过胃或幽门后(小肠)喂养管输送。后一种选择过去更具挑战性,除非通过内镜或介入放射学放置喂养管。多项技术进步促进了幽门后喂养,包括一种新型的电磁可视化空肠喂养管系统(CORTRAK肠内通路系统)。我们报告一例50岁女性因这项新技术导致鼻咽穿孔的病例。该并发症得到及时识别,并通过保守措施成功处理。本病例说明了识别喂养管放置并发症高危患者的重要性、细致的放置技术以及插管后适当的随访。