Li G, Shen X, Ke L, Tong Z, Li W
Department of Surgery Intensive Care Unit, Institute of General Surgery, Jinling hospital, Nanjing, Jiangsu province, China.
Eur J Clin Nutr. 2015 Oct;69(10):1176-7. doi: 10.1038/ejcn.2015.135. Epub 2015 Aug 26.
Enteral feeding is the preferred way to provide nutritional support in patients with high nutritional risk but relatively normal gastrointestinal function; thus, establishing a safe and a reliable pathway of enteral nutrition (EN) is of great importance. There are many techniques for placing the feeding tube, such as blind placement at bedside, assisting by fluoroscopy and endoscopy, surgical and so on. Despite these variable techniques, it is still difficult to obtain the pathway for EN in some specific patients. Here, we present a recent case of infected pancreatic/peripancreatic necrosis complicated by a duodenal enteric fistula in whom we establish the feeding pathway extraordinarily. Briefly, after several failed attempts of placing the nasojejunal feeding tube, a jejunal feeding tube was placed percutaneously guided by computed tomography, and EN was successfully applied thereafter. With the implementation of EN, duodenal fistula healed without surgical intervention. As EN is pivotal for the recovery of duodenal fistula, this novel approach could be beneficial in selected patients.
肠内营养是为营养风险高但胃肠道功能相对正常的患者提供营养支持的首选方式；因此，建立安全可靠的肠内营养（EN）途径至关重要。放置喂养管有多种技术，如床边盲插、透视和内镜辅助、外科手术等。尽管有这些不同的技术，但在一些特定患者中仍难以获得EN途径。在此，我们介绍最近一例感染性胰腺/胰周坏死合并十二指肠肠瘘的病例，我们通过特殊方法建立了喂养途径。简要来说，在多次尝试放置鼻空肠喂养管失败后，在计算机断层扫描引导下经皮放置了空肠喂养管，此后成功实施了EN。随着EN的实施，十二指肠瘘未经手术干预而愈合。由于EN对十二指肠瘘的恢复至关重要，这种新方法可能对特定患者有益。
