Enteral nutrition associated non-occlusive bowel ischemia.
10.4174/jkss.2012.83.3.171
- Author:
Jun Gyo GWON
1
;
Young Ju LEE
;
Kyu Hyouck KYOUNG
;
Young Hwan KIM
;
Suk Kyung HONG
Author Information
1. Division of Trauma and Surgical Critical Care, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. skhong94@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Enteral nutrition;
Acute mesenteric ischemia;
Intensive care units;
Sepsis
- MeSH:
Enteral Nutrition;
Humans;
Intensive Care Units;
Ischemia;
Lung;
Mucous Membrane;
Necrosis;
Sepsis;
Shock, Septic;
Vascular Diseases
- From:Journal of the Korean Surgical Society
2012;83(3):171-174
- CountryRepublic of Korea
- Language:English
-
Abstract:
We describe two patients, with no previous history of vascular problems but poor lung function, who experienced septic shock due to bowel ischemia. Both were fed an enteral formula rich in fiber using a feeding tube and experienced septic shock with regular enteral feeding. Surgical finding showed hemorrhagic ischemia in the bowel. The pathologic finding suggests these changes may have been due to inspissations of bowel contents, which may put direct pressure on the mucosa of the bowel wall, leading to local impairment of mucosal and submucosal blood flow with subsequent bowel necrosis. Bowel ischemia may have been precipitated by an increased mesenteric blood flow requirement in combination with a metabolically stressed bowel. Patients in the intensive care unit fed a fiber-rich enteral formula may have inspissated bowel contents, leading to bowel ischemia, suggesting that the use of fiber-rich formula should be limited in patients at high-risk of bowel ischemia.
